University Psychiatry Hospital, Bern, Switzerland. eliane.siegenthaler@gef
J Am Acad Child Adolesc Psychiatry. 2012 Jan;51(1):8-17.e8. doi: 10.1016/j.jaac.2011.10.018. Epub 2011 Dec 3.
Mental illness in parents affects the mental health of their children. A systematic review and a meta-analysis of the effectiveness of interventions to prevent mental disorders or psychological symptoms in the offspring were performed.
The Cochrane, MEDLINE, EMBASE, and PsycINFO databases were searched for randomized controlled trials of interventions in parents with mental disorders. Outcomes in the child included incident mental disorders of the same nature and internalizing (negative emotions, depressive symptoms, anxiety) or externalizing (hyperactivity, aggressiveness, behavioral problems) symptoms. Relative risks and standardized mean differences in symptom scores were combined in random-effects meta-analysis.
Thirteen trials including 1,490 children were analyzed. Interventions included cognitive, behavioral, or psychoeducational components. Seven trials assessed the incidence of mental disorders and seven trials assessed symptoms. In total 161 new diagnoses of mental illness were recorded, with interventions decreasing the risk by 40% (combined relative risk 0.60, 95% CI 0.45-0.79). Symptom scores were lower in the intervention groups: standardized mean differences were -0.22 (95% CI -0.37 to -0.08) for internalizing symptoms (p = .003) and -0.16 (95% confidence interval -0.36 to 0.04) for externalizing symptoms (p = .12).
Interventions to prevent mental disorders and psychological symptoms in the offspring of parents with mental disorders appear to be effective.
父母的精神疾病会影响其子女的心理健康。对预防精神障碍或心理症状在子女中发生的干预措施的有效性进行了系统评价和荟萃分析。
对患有精神障碍的父母的干预措施进行了 Cochrane、MEDLINE、EMBASE 和 PsycINFO 数据库的随机对照试验搜索。儿童的结局包括相同性质的精神障碍和内化(负性情绪、抑郁症状、焦虑)或外化(多动、攻击性、行为问题)症状的发病情况。症状评分的相对风险和标准化均数差采用随机效应荟萃分析进行合并。
分析了包括 1490 名儿童的 13 项试验。干预措施包括认知、行为或心理教育成分。7 项试验评估了精神障碍的发病率,7 项试验评估了症状。共记录了 161 例新的精神疾病诊断,干预措施使风险降低了 40%(合并相对风险 0.60,95%CI 0.45-0.79)。干预组的症状评分较低:内化症状的标准化均数差为-0.22(95%CI-0.37 至-0.08)(p=0.003),外化症状的标准化均数差为-0.16(95%CI-0.36 至 0.04)(p=0.12)。
针对有精神障碍父母的子女预防精神障碍和心理症状的干预措施似乎是有效的。