减少或预防医生常见精神障碍和自杀症状的干预措施的系统回顾和荟萃分析

IF 8.7
Katherine Petrie, Mikayla Gregory, Daniel A. J. Collins, Aimee Gayed, Samineh Sanatkar, Kimberlie Dean, Mark Deady, Samuel B. Harvey
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引用次数: 0

摘要

我们对减少或预防医生常见精神障碍(CMD)症状和自杀的干预措施的有效性进行了最新的系统回顾和荟萃分析。数据库中检索了减少或预防医生抑郁、焦虑、一般心理困扰或自杀的干预措施的随机和非随机对照试验。主要结局是干预后CMD症状的差异。进行随机效应荟萃分析、亚组分析和敏感性分析。24项研究纳入定性综合,其中21项纳入meta分析。与对照组相比,医生指导的干预在干预后显著降低了医生的CMD症状(标准化平均差0.45;95%置信区间0.26-0.65;P < 0.001;中等异质性)和随访,效应量小到中等。初步研究结果表明,以小组为基础、面对面和以技能为基础的干预措施有望减轻医生的CMD症状。迫切需要对组织层面的干预措施进行研究。系统评价注册号:PROSPERO CRD42018091646。医生面临着高比率的常见精神障碍(cmd)和自杀,但有效的干预措施仍未得到充分探索。本系统综述和荟萃分析综合了有关干预措施的最新证据,发现一系列医生指导的干预措施可减轻CMD的症状,并且这些适度效果可长期保持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A systematic review and meta-analysis of interventions to reduce or prevent symptoms of common mental disorders and suicidality in physicians

A systematic review and meta-analysis of interventions to reduce or prevent symptoms of common mental disorders and suicidality in physicians
We conducted an updated systematic review and meta-analysis on the effectiveness of interventions for reducing or preventing symptoms of common mental disorder (CMD) and suicidality among physicians. Databases were searched for randomized and non-randomized controlled trials of interventions to reduce or prevent depression, anxiety, general psychological distress or suicidality among physicians. The primary outcome was differences in symptoms of CMD following intervention. Random-effects meta-analyses and subgroup and sensitivity analyses were conducted. Twenty-four studies were included in the qualitative synthesis, of which 21 were included in the meta-analysis. Compared with controls, physician-directed interventions significantly reduced symptoms of CMD among physicians at post-intervention (standardized mean difference 0.45; 95% confidence interval 0.26–0.65; P < 0.001; moderate heterogeneity) and follow-up with a small to moderate effect size. Preliminary findings suggest that group-based, face-to-face and skills-based interventions show promise for reducing symptoms of CMD among physicians. Research regarding organizational-level interventions is urgently required. Systematic review registration: PROSPERO CRD42018091646 . Physicians face high rates of common mental disorders (CMDs) and suicidality, yet effective interventions remain underexplored. This systematic review and meta-analysis synthesizing the latest evidence on interventions finds that a range of physician-directed interventions reduces symptoms of CMD and that these moderate effects are maintained over time.
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