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人际心理治疗对创伤后应激障碍的疗效:系统评价和荟萃分析。

Efficacy of interpersonal psychotherapy for post-traumatic stress disorder: A systematic review and meta-analysis.

机构信息

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.

出版信息

J Affect Disord. 2020 Mar 1;264:286-294. doi: 10.1016/j.jad.2019.12.021. Epub 2019 Dec 14.

Abstract

BACKGROUND

Evidence for the efficacy of treatments for post-traumatic stress disorder (PTSD) is urgently required. This systematic review and meta-analysis examines the efficacy of interpersonal psychotherapy (IPT) in reducing the symptoms of PTSD.

METHODS

Five databases were searched from inception until November 2018 to identify randomized controlled trials (RCTs) that assessed the efficacy of IPT in patients with PTSD symptoms. The reference lists of included studies were also hand searched. A random effects model was used to estimate changes in a clinician-administered PTSD scale, or self-reported symptoms.

RESULTS

Of 509 screened abstracts, ten clinical trials (11 study arms) involving 755 patients with PTSD symptoms were included. Nine studies (10 study arms) were included in the meta-analysis. The overall standardized mean difference was -0.44 (CI: -0.69, -0.19), p = 0.0005. This represents a change in the clinically administrated PTSD Scale (CAPS) of approximately 12 points. IPT was not superior to other active controls, such as medication and non-IPT psychotherapies, but was significantly superior to passive controls, such as waiting list and educational pamphlets.

LIMITATIONS

Most studies modified the IPT protocol and did not comprehensively assess clinician fidelity to the protocol. The included studies generally had small sample sizes and were of limited quality.

CONCLUSIONS

IPT may be an effective treatment for PTSD, but clinical trials with larger sample sizes and improved methodology are required to confirm effects.

摘要

背景

迫切需要证据来证明创伤后应激障碍(PTSD)治疗方法的疗效。本系统评价和荟萃分析检查了人际心理治疗(IPT)在减轻 PTSD 症状方面的疗效。

方法

从建库到 2018 年 11 月,我们检索了 5 个数据库,以确定评估 IPT 对 PTSD 症状患者疗效的随机对照试验(RCT)。还对手册搜索了纳入研究的参考文献列表。采用随机效应模型来估计临床医生管理的 PTSD 量表或自我报告症状的变化。

结果

在筛选的 509 篇摘要中,有 10 项临床试验(11 个研究臂)纳入了 755 名 PTSD 症状患者。9 项研究(10 个研究臂)纳入了荟萃分析。总体标准化均数差为-0.44(CI:-0.69,-0.19),p=0.0005。这代表临床管理 PTSD 量表(CAPS)的变化约为 12 分。IPT 并不优于其他活性对照物,如药物和非 IPT 心理治疗,但明显优于被动对照物,如等待名单和教育小册子。

局限性

大多数研究修改了 IPT 方案,并且没有全面评估临床医生对方案的遵守程度。纳入的研究通常样本量较小,质量有限。

结论

IPT 可能是 PTSD 的一种有效治疗方法,但需要更大样本量和改进方法学的临床试验来确认疗效。

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