Department of Physiotherapy, Manchester Metropolitan University, UK.
Aging Ment Health. 2010 Aug;14(6):637-51. doi: 10.1080/13607860903483094.
OBJECTIVES: Osteoarthritis (OA) is the most common form of arthritis, and depressive symptoms are common in older people with arthritic pain. However, relatively little attention has been given to the efficacy of interventions that may be beneficial for older people with OA with concomitant depressive symptoms. METHODS: The aim of this review was to evaluate data from clinical trials testing the effectiveness of various interventions for older patients suffering from OA and depression. Systematic searches were conducted on MEDLINE, CINAHL, Scopus, PsychInfo, Web of Knowledge and Pubmed (January 1990-July 2009). RESULTS: Fourteen studies were identified and examined. Interventions highlighted in these studies were: patient education programmes (N = 3); cognitive behavioural therapy (CBT) (N = 2); depression care and pharmacological intervention (N = 2); and exercise therapy (N = 7). 11 out of 14 interventions showed some improvement in patients' depressive symptoms in the short term. Three of the interventions did not affect depressive symptoms on patients with OA. CONCLUSIONS: There was some evidence to suggest that the intervention of CBT, integrated depression care management and exercise therapy were associated with reduced depressive symptoms in the short term. However, the long-term benefits of depression management in patients with OA with co-morbid depression are unknown. Future well-controlled clinical trials are needed.
目的:骨关节炎(OA)是最常见的关节炎形式,而在患有关节炎疼痛的老年人中,抑郁症状很常见。然而,对于可能对患有 OA 合并抑郁症状的老年人有益的干预措施的疗效,关注相对较少。
方法:本综述的目的是评估临床试验数据,这些试验测试了各种干预措施对患有 OA 和抑郁症的老年患者的有效性。对 MEDLINE、CINAHL、Scopus、PsychInfo、Web of Knowledge 和 Pubmed(1990 年 1 月至 2009 年 7 月)进行了系统检索。
结果:确定并检查了 14 项研究。这些研究中突出的干预措施是:患者教育计划(N = 3);认知行为疗法(CBT)(N = 2);抑郁护理和药物干预(N = 2);以及运动疗法(N = 7)。14 项干预措施中有 11 项在短期内改善了患者的抑郁症状。其中 3 项干预措施对患有 OA 的患者的抑郁症状没有影响。
结论:有一些证据表明,CBT、综合抑郁护理管理和运动疗法的干预措施与短期抑郁症状的减轻有关。然而,尚不清楚在患有 OA 合并抑郁症状的患者中进行抑郁管理的长期益处。需要进行未来的、精心设计的临床试验。
Aging Ment Health. 2010-8
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