Topolovec-Vranic Jane, Mansoor Yasmeen, Ennis Naomi, Lightfoot David
St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada.
University of Toronto, 563 Spadina Crescent, Toronto, Ontario, M5S 2J7, Canada.
Syst Rev. 2015 Apr 7;4:42. doi: 10.1186/s13643-015-0032-4.
Depression is a common comorbidity in individuals with cognitive impairment. Those with cognitive impairments face unique challenges in receiving the benefits of many conventional therapies for depression, and may have poorer outcomes in areas such as recovery and quality of life. However, the stigmatization of mental health disorders, cost barriers and physical disabilities may prevent these individuals from seeking mental health care. An online, self-help intervention specifically developed for adults with cognitive deficits and depression may be particularly beneficial to this population. We aim to inform the design of such an intervention through a systematic review by answering the following research question: among adults with cognitive impairment (including those with acquired brain injuries or neurodegenerative diseases), which technology-amenable interventions have been shown to effectively decrease symptoms of depression? Specifically, psychotherapeutic and/or behavioural interventions that could be delivered in a self-guided, online system will be included.
Comprehensive electronic searches will be conducted in MEDLINE, EMBASE, PsycINFO and CINAHL. Additional studies will be obtained through manually searching the references of relevant systematic reviews, contacting primary authors of select articles and tracking conference proceedings and trial registries. Article titles and abstracts will be screened using predefined eligibility criteria, and then judged for their amenability to the proposed self-help, technology-based intervention. The full text of those articles with selected interventions will then be screened to determine final eligibility for inclusion. Included articles will be categorized by intervention type and assessed for risk of bias using the Cochrane Effective Practice and Organization of Care Risk of Bias tool for non-randomized trials, controlled before-after studies and interrupted time series. The primary outcome will be a change in score on a validated depression scale, and adverse events will be documented as a secondary outcome. After data extraction from selected articles, pooling of data and meta-analysis will be conducted if a sufficient pool of studies with comparable methodology and quality are identified. Alternatively, plain language summaries will be developed. The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.
PROSPERO CRD42014014417.
抑郁症是认知障碍患者中常见的共病。认知障碍患者在接受许多传统抑郁症治疗的益处方面面临独特挑战，并且在康复和生活质量等方面可能有较差的结果。然而，心理健康障碍的污名化、成本障碍和身体残疾可能会阻止这些人寻求心理健康护理。专门为患有认知缺陷和抑郁症的成年人开发的在线自助干预可能对这一人群特别有益。我们旨在通过系统评价来为这种干预措施的设计提供信息，回答以下研究问题：在患有认知障碍的成年人（包括那些患有后天性脑损伤或神经退行性疾病的人）中，哪些适合技术的干预措施已被证明能有效减轻抑郁症状？具体而言，将包括可以在自我指导的在线系统中提供的心理治疗和/或行为干预。
将在MEDLINE、EMBASE、PsycINFO和CINAHL中进行全面的电子检索。通过手动搜索相关系统评价的参考文献、联系选定文章的第一作者以及跟踪会议记录和试验注册来获取其他研究。将使用预定义的纳入标准筛选文章标题和摘要，然后判断它们是否适合提议的基于技术的自助干预。然后将筛选那些具有选定干预措施的文章的全文，以确定最终纳入资格。纳入的文章将按干预类型分类，并使用Cochrane有效实践和护理组织偏倚风险工具对非随机试验、前后对照研究和中断时间序列进行偏倚风险评估。主要结局将是经过验证的抑郁量表得分的变化，不良事件将作为次要结局记录。从选定文章中提取数据后，如果确定有足够数量的方法和质量可比的研究，则将进行数据合并和荟萃分析。或者，将编写通俗易懂的总结。将使用推荐分级评估、制定和评价（GRADE）系统评估证据质量。
PROSPERO CRD42014014417。
