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心理干预对大学生心理健康障碍的预防和治疗效果:系统评价和荟萃分析。

The efficacy of psychological interventions for the prevention and treatment of mental health disorders in university students: A systematic review and meta-analysis.

机构信息

Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.

Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK; National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK.

出版信息

J Affect Disord. 2021 Feb 1;280(Pt A):381-406. doi: 10.1016/j.jad.2020.10.060. Epub 2020 Nov 2.

Abstract

BACKGROUND

Mental health problems are becoming increasingly prevalent among students and adequate support should be provided to prevent and treat mental health disorders in those at risk.

METHODS

This systematic review and meta-analysis examined the efficacy of psychological interventions for students, with consideration of how adaptions to intervention content and delivery could improve outcomes. We searched for randomised controlled trials (RCTs) of interventions in students with or at risk of mental health problems and extracted data for study characteristics, symptom severity, wellbeing, educational outcomes, and attrition. Eighty-four studies were included.

RESULTS

Promising effects were found for indicated and selective interventions to treat anxiety disorders, depression and eating disorders. PTSD and self-harm data was limited, and did not demonstrate significant effects. Relatively few trials adapted intervention delivery to student-specific concerns, and overall adapted interventions showed no benefit over non-adapted interventions. There was some suggestion that adaptions based on empirical evidence and provision of additional sessions, and transdiagnostic models may yield some benefits.

LIMITATIONS

The review is limited by the often poor quality of the literature and exclusion of non-published data.

CONCLUSIONS

Interventions for students show benefit though uncertainty remains around how best to optimise treatment delivery and content for students. Additional research into content targeting specific underlying mechanisms of problems and transdiagnostic approaches to provision could be promising avenues for further research.

摘要

背景

心理健康问题在学生中越来越普遍,应该提供足够的支持,以预防和治疗有风险的心理健康障碍。

方法

本系统评价和荟萃分析研究了针对学生的心理干预措施的疗效,并考虑了干预内容和实施方式的调整如何改善结果。我们搜索了针对有或有心理健康问题风险的学生的干预措施的随机对照试验(RCT),并提取了研究特征、症状严重程度、幸福感、教育成果和辍学的数据。共有 84 项研究纳入分析。

结果

针对焦虑症、抑郁症和饮食障碍的有针对性和选择性干预措施显示出了有希望的效果。创伤后应激障碍和自残的数据有限,没有显示出显著的效果。相对较少的试验针对学生的具体问题调整了干预措施的实施方式,总体而言,调整后的干预措施并没有比非调整后的干预措施更有优势。有一些证据表明,基于实证证据的调整和提供额外的疗程,以及跨诊断模型可能会带来一些好处。

局限性

该综述受到文献质量往往较差和排除未发表数据的限制。

结论

针对学生的干预措施显示出了益处,但仍不确定如何优化治疗的实施方式和内容以满足学生的需求。进一步研究针对特定潜在问题机制的内容和提供跨诊断方法可能是进一步研究的有前途的途径。

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