O'Connor Daniel W, Ames David, Gardner Betina, King Madeleine
Department of Psychological Medicine, Monash University, Melbourne, Australia.
Int Psychogeriatr. 2009 Apr;21(2):241-51. doi: 10.1017/S1041610208008223. Epub 2009 Jan 13.
This paper provides a systematic review of selected experimental studies of the effectiveness of psychosocial treatments in reducing psychological symptoms in dementia (e.g. anxiety, depression, irritability and social withdrawal).
English language reports published or in press by February 2008 were identified by means of database searches and checks of previous reviews. Reports were appraised with respect to study design, participants' characteristics and reporting details. Because people with dementia often respond positively to personal contact, studies were included only if control conditions entailed similar levels of social attention or if one treatment was compared with another.
Only 12 of 48 relevant papers met every specification. Treatments proved more effective in reducing psychological symptoms than an attention control condition or another treatment in only six of the 12 selected studies. Interventions with moderate effect sizes included music and recreation therapy.
Some psychosocial interventions appear to have specific therapeutic properties, over and above those due to the benefits of participating in a clinical trial. Their effects were generally modest with an unknown duration of action. This limited efficacy suggests that treatments will work best in specific, time-limited situations, tailored to individuals' requirements. There is no preferred method to rate psychological symptoms.
本文对部分关于心理社会治疗在减轻痴呆症患者心理症状（如焦虑、抑郁、易怒和社交退缩）方面有效性的实验研究进行了系统综述。
通过数据库检索和查阅以往综述，确定了截至2008年2月已发表或即将发表的英文报告。对报告的研究设计、参与者特征和报告细节进行了评估。由于痴呆症患者通常对人际接触反应积极，因此仅纳入那些对照条件涉及相似社会关注度水平的研究，或者将一种治疗方法与另一种治疗方法进行比较的研究。
48篇相关论文中只有12篇符合所有标准。在12项入选研究中，只有6项研究表明治疗在减轻心理症状方面比注意力控制条件或另一种治疗方法更有效。中等效应量的干预措施包括音乐和娱乐疗法。
一些心理社会干预措施似乎具有特定的治疗特性，超出了参与临床试验所带来的益处。其效果通常较为有限，作用持续时间未知。这种有限的疗效表明，治疗方法在针对个体需求的特定、限时情况下效果最佳。目前尚无评估心理症状的首选方法。
