Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA.
Graduate School of Psychology, California Lutheran University, 60 West Olsen Road #4250, Thousand Oaks, CA, 91360, USA.
Drug Alcohol Depend. 2019 Sep 1;202:134-148. doi: 10.1016/j.drugalcdep.2019.04.045. Epub 2019 Jul 15.
Spiritual/religious (S/R) interventions are commonly used to treat substance use problems, but this is the first systematic review and meta-analysis to examine their efficacy for these problems.
Ten electronic databases were searched to identify eligible studies (i.e., randomized controlled trials) published between January 1990 and February 2018 that examined S/R interventions' efficacy for substance use or psycho-social-spiritual outcomes. Two reviewers independently screened studies, extracted data, and assessed risks of bias. Robust variance estimation in meta-regression was used to estimate effect sizes and conduct moderator analysis.
Twenty studies comprising 3700 participants met inclusion criteria. Four studies used inactive controls, 14 used active controls, and two used both inactive and active controls and were therefore included in estimating both absolute and relative effect sizes. The absolute effect of S/R interventions (compared with inactive controls such as no treatment) was moderate but non-significant (six studies, d = .537, 95% confidence interval [CI] = -.316, 1.390), possibly due to low power. The relative effect of S/R interventions (compared with other interventions) was statistically significant (16 studies, d = .176, 95% CI = .001, .358). Because only 12-step-oriented interventions were compared with other interventions, this finding does not apply to the relative effect of non-12-step-oriented S/R interventions. Moderator analysis showed that relative effect sizes differ significantly by country.
We found evidence of S/R interventions' efficacy in helping people with substance use problems. More high-quality efficacy studies of non-12-step-oriented S/R interventions for substance use problems are needed.
精神/宗教干预措施常用于治疗物质使用问题，但这是首次系统评价和荟萃分析，旨在研究这些干预措施对这些问题的疗效。
检索了 10 个电子数据库，以确定 1990 年 1 月至 2018 年 2 月期间发表的、评估精神/宗教干预措施对物质使用或心理-社会-精神结果的疗效的合格研究（即随机对照试验）。两名审查员独立筛选研究、提取数据并评估偏倚风险。使用稳健方差估计的荟萃回归来估计效应大小并进行调节分析。
有 20 项研究符合纳入标准，共纳入 3700 名参与者。其中 4 项研究使用了无活性对照，14 项研究使用了活性对照，2 项研究同时使用了无活性和活性对照，因此用于估计绝对和相对效应大小。与无活性对照（如无治疗）相比，精神/宗教干预措施的绝对效果中等但不显著（6 项研究，d=0.537，95%置信区间[CI]=-0.316，1.390），可能是由于效力不足。与其他干预措施相比，精神/宗教干预措施的相对效果具有统计学意义（16 项研究，d=0.176，95%CI=0.001，0.358）。由于仅将 12 步导向干预措施与其他干预措施进行了比较，因此这一发现不适用于非 12 步导向精神/宗教干预措施的相对效果。调节分析表明，相对效应大小在国家之间存在显著差异。
我们发现精神/宗教干预措施在帮助有物质使用问题的人方面具有疗效的证据。需要更多高质量的非 12 步导向精神/宗教干预措施治疗物质使用问题的疗效研究。
