谈话疗法治疗痴呆患者的焦虑和抑郁:一项范围荟萃综述。

IF 2.7 3区 医学 Q2 PSYCHIATRY
Georgina Charlesworth, Cassie Eastham, Lydia Morris
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引用次数: 0

摘要

背景:焦虑和抑郁症状在痴呆症患者(痴呆症患者和家庭护理人员)中很常见。有许多关于心理干预减轻痴呆症患者和家庭照顾者的压力和痛苦的评论,但与支持NHS焦虑和抑郁谈话疗法(TTad)的证据基础很少交叉。目的:通过TTad视角对痴呆患者及其家庭照护者的心理干预文献进行综述,为两种文献之间的联系提供桥梁。方法:我们对ttad推荐的用于痴呆症患者和家庭护理人员的治疗方法进行了荟萃分析,包括认知行为疗法(CBT)、行为激活、问题解决、抑郁症咨询和基于正念的认知疗法。结果:所有关于认知和行为疗法的荟萃分析综述(9项针对家庭护理人员,1项针对痴呆症患者的Cochrane综述)都证明了行为激活和cbt知情干预在减轻抑郁症状方面的有效性。对焦虑的研究较少,对痴呆症患者没有积极的研究结果。心理教育是减少护理人员焦虑最有效的方法。对护理人员进行正念干预(MBIs)的荟萃分析表明,抑郁和焦虑症状均有所减轻。结论:支持TTad和痴呆患者心理干预的文献存在本体论和方法上的差异。为了改善痴呆症患者和家庭照顾者获得TTad的机会,需要改变研究方法、TTad数据收集和提供服务的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Talking therapies for anxiety and depression in people affected by dementia: A scoping meta-review.

Background: Symptoms of anxiety and depression are common in people affected by dementia (people with dementia and family carers). There are many reviews of psychological interventions to reduce stress and distress in people with dementia and family carers, but little cross-fertilisation with the evidence base underpinning NHS Talking Therapies for anxiety and depression (TTad).

Objectives: To review the psychological intervention literature for people with dementia and their family carers through the lens of TTad, thus providing a bridge between the two literatures.

Methods: We undertook a rapid scoping review of meta-analyses of TTad-recommended therapies used with people with dementia and family carers, including cognitive-behavioural therapies (CBT), behavioural activation, problem-solving, counselling for depression and mindfulness-based cognitive therapy.

Results: All meta-analytic reviews of cognitive and behavioural therapies (nine with family carers and a Cochrane review with people with dementia) demonstrated the effectiveness of behavioural activation and CBT-informed interventions in reducing symptoms of depression. Anxiety was less frequently studied, with no positive findings found for people with dementia. Psychoeducation was the most effective approach for anxiety reduction in carers. Evidence from meta-analyses of mindfulness-based interventions (MBIs) for carers showed reduced symptoms of both depression and anxiety.

Conclusions: There are ontological and methodological differences in the literatures underpinning TTad and psychological interventions for people affected by dementia. To improve access to TTad for people with dementia and family carers, changes are required to research methodologies, TTad data collection and approaches to service delivery.

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来源期刊
CiteScore
6.10
自引率
5.90%
发文量
68
审稿时长
6 months
期刊介绍: Psychology and Psychotherapy: Theory Research and Practice (formerly The British Journal of Medical Psychology) is an international scientific journal with a focus on the psychological and social processes that underlie the development and improvement of psychological problems and mental wellbeing, including: theoretical and research development in the understanding of cognitive and emotional factors in psychological problems; behaviour and relationships; vulnerability to, adjustment to, assessment of, and recovery (assisted or otherwise) from psychological distresses; psychological therapies with a focus on understanding the processes which affect outcomes where mental health is concerned.
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