促进青少年良好心理健康的普遍和选择性干预措施：系统评价和荟萃分析。
Universal and selective interventions to promote good mental health in young people: Systematic review and meta-analysis.
机构信息
Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.
Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
出版信息
Eur Neuropsychopharmacol. 2020 Dec;41:28-39. doi: 10.1016/j.euroneuro.2020.10.007. Epub 2020 Nov 6.
Promotion of good mental health in young people is important. Our aim was to evaluate the consistency and magnitude of the efficacy of universal/selective interventions to promote good mental health. A systematic PRISMA/RIGHT-compliant meta-analysis (PROSPERO: CRD42018088708) search of Web of Science until 04/31/2019 identified original studies comparing the efficacy of universal/selective interventions for good mental health vs a control group, in samples with a mean age <35 years. Meta-analytical random-effects model, heterogeneity statistics, assessment of publication bias, study quality and sensitivity analyses investigated the efficacy (Hedges' g=effect size, ES) of universal/selective interventions to promote 14 good mental health outcomes defined a-priori. 276 studies were included (total participants: 159,508, 79,142 interventions and 80,366 controls), mean age=15.0 (SD=7.4); female=56.0%. There was a significant overall improvement in 10/13 good mental health outcome categories that could be meta-analysed: compared to controls, interventions significantly improved (in descending order of magnitude) mental health literacy (ES=0.685, p<0.001), emotions (ES=0.541, p<0.001), self-perceptions and values (ES=0.49, p<0.001), quality of life (ES=0.457, p=0.001), cognitive skills (ES=0.428, p<0.001), social skills (ES=0.371, p<0.001), physical health (ES=0.285, p<0.001), sexual health (ES=0.257, p=0.017), academic/occupational performance (ES=0.211, p<0.001) and attitude towards mental disorders (ES=0.177, p=0.006). Psychoeducation was the most effective intervention for promoting mental health literacy (ES=0.774, p<0.001) and cognitive skills (ES=1.153, p=0.03). Physical therapy, exercise and relaxation were more effective than psychoeducation and psychotherapy for promoting physical health (ES=0.498, p<0.001). In conclusion, several universal/selective interventions can be effective to promote good mental health in young people. Future research should consolidate and extend these findings.
促进年轻人的良好心理健康很重要。我们的目的是评估普遍性/选择性干预措施促进良好心理健康的一致性和效果大小。一项系统的 PRISMA/RIGHT 符合的荟萃分析（PROSPERO：CRD42018088708）对 Web of Science 进行了搜索，直到 2019 年 4 月 31 日，以确定比较普遍性/选择性干预措施对良好心理健康与对照组的功效的原始研究，样本的平均年龄<35 岁。使用元分析随机效应模型、异质性统计、出版偏倚评估、研究质量和敏感性分析，研究了普遍性/选择性干预措施对促进先前定义的 14 种良好心理健康结果的效果（Hedges' g=效应大小，ES）。共纳入 276 项研究（总参与者：159508 人，79142 项干预措施和 80366 项对照），平均年龄=15.0（SD=7.4）；女性=56.0%。在可进行元分析的 13 种良好心理健康结果类别中，有 10 种有显著的整体改善：与对照组相比，干预措施显著改善（按效果大小降序排列）心理健康素养（ES=0.685，p<0.001）、情绪（ES=0.541，p<0.001）、自我认知和价值观（ES=0.49，p<0.001）、生活质量（ES=0.457，p=0.001）、认知技能（ES=0.428，p<0.001）、社交技能（ES=0.371，p<0.001）、身体健康（ES=0.285，p<0.001）、性健康（ES=0.257，p=0.017）、学业/职业表现（ES=0.211，p<0.001）和对精神障碍的态度（ES=0.177，p=0.006）。心理健康教育是促进心理健康素养（ES=0.774，p<0.001）和认知技能（ES=1.153，p=0.03）最有效的干预措施。体育疗法、运动和放松比心理健康教育和心理治疗更能促进身体健康（ES=0.498，p<0.001）。总之，一些普遍性/选择性干预措施可以有效地促进年轻人的良好心理健康。未来的研究应该巩固和扩展这些发现。
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