Centre of Global Mental Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LG20, Keppel Street, London, WC1E 7HT, UK.
Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Urb. Ingeniería-San Martín de Porres, Lima, Peru.
Soc Psychiatry Psychiatr Epidemiol. 2018 Feb;53(2):107-119. doi: 10.1007/s00127-017-1469-7. Epub 2017 Dec 12.
Mental disorders are a major contributor to the global burden of disease and disability, and can be extremely costly at both individual and community level. Social capital, (SC) defined as an individual's social relationships and participation in community networks, may lower the risk of mental disorders while increasing resilience capacity, adaptation and recovery. SC interventions may be a cost-effective way of preventing and ameliorating these conditions. However, the impact of these SC interventions on mental health still needs research.
We conducted a systematic review of SC-based interventions to investigate their effect on mental health outcomes from controlled, quasi-experimental studies or pilot trials. We searched twelve academic databases, three clinical trials registries, hand-searched references and contacted field experts. Studies' quality was assessed with the Cochrane Risk of Bias tools for randomized and non-randomized studies.
Seven studies were included in the review, published between 2006 and 2016. There was substantial heterogeneity in the definitions of both SC and mental disorders among the studies, preventing us from calculating pooled effect sizes. The interventions included community engagement and educative programs, cognitive processing therapy and sociotherapy for trauma survivors, and neighbourhood projects.
There are paucity of SC interventions investigating the effect on mental health outcomes. This study showed that both SC scores and mental health outcomes improved over time but there was little evidence of benefit compared to control groups in the long term. Further high-quality trials are needed, especially among adverse populations to assess sustainability of effect.
精神障碍是全球疾病和残疾负担的主要原因,无论是对个人还是对社区而言,其成本都极高。社会资本(SC)定义为个人的社会关系和参与社区网络的程度,它可能降低精神障碍的风险,同时提高适应能力、恢复能力和韧性。SC 干预措施可能是预防和改善这些情况的一种具有成本效益的方法。然而,这些 SC 干预措施对心理健康的影响仍需要研究。
我们对基于 SC 的干预措施进行了系统评价,以调查它们对来自对照、准实验研究或试点试验的心理健康结果的影响。我们搜索了 12 个学术数据库、3 个临床试验注册处、手动搜索参考文献并联系了领域专家。使用 Cochrane 随机和非随机研究偏倚风险工具评估了研究的质量。
该综述纳入了 7 项研究,发表时间为 2006 年至 2016 年。由于研究之间对 SC 和精神障碍的定义存在很大差异,我们无法计算汇总效应大小。干预措施包括社区参与和教育计划、创伤幸存者的认知加工疗法和社会疗法以及邻里项目。
目前关于 SC 干预对心理健康结果影响的研究很少。本研究表明,SC 评分和心理健康结果随着时间的推移而改善,但与对照组相比,长期来看几乎没有证据表明有获益。需要开展更多高质量的试验,特别是针对弱势群体,以评估效果的可持续性。