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基于冥想的身心干预对精神障碍的疗效:17 项随机对照试验荟萃分析的元综述。

The efficacy of meditation-based mind-body interventions for mental disorders: A meta-review of 17 meta-analyses of randomized controlled trials.

机构信息

KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium.

South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK; Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.

出版信息

J Psychiatr Res. 2021 Feb;134:181-191. doi: 10.1016/j.jpsychires.2020.12.048. Epub 2020 Dec 21.


DOI:10.1016/j.jpsychires.2020.12.048
PMID:33388701
Abstract

There is increasing interest in the potential efficacy of meditation-based mind-body interventions (MBIs) within mental health care. We conducted a systematic metareview of the published randomized control trial (RCT) evidence. MEDLINE/PubMed, PsycARTICLES and EMBASE were searched from inception to 06/2020 examining MBIs (mindfulness, qigong, tai chi, yoga) as add-on or monotherapy versus no treatment, minimal treatment and passive and active control conditions in people with a mental disorder. The quality of the methods of the included meta-analyses using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and the methodological quality of the RCTs using AMSTAR-Plus. Sixteen (94%) of 17 meta-analyses had good overall methodological quality. The content validity of the included RCTs was considered good in 9 (53%) meta-analyses. In meta-analyses with good methodological quality (AMSTAR 8≤) and content validity (AMSTAR+ 4≤), large effect sizes (0.80 or higher) were observed for mindfulness in schizophrenia and in ADHD, a moderate (0.50 ≤ 0.80) effect size for mindfulness in PTSD and a small (0.20 < 0.50) effect size for yoga in schizophrenia No serious adverse events were reported (n RCTs = 43, n in the MBI arms = 1774), while the attrition rates were comparable with the rates in passive and active control conditions. Our meta-review demonstrates that mindfulness and to a lesser extent yoga may serve as an efficacious supplement to pharmacotherapy, and psychotherapy and can be complementary in healthy lifestyle interventions for people with mental disorders. Meta-analytic evidence of high methodological quality and content validity of included trials is currently lacking for qigong and tai chi.

摘要

人们对基于冥想的身心干预(MBI)在精神卫生保健中的潜在疗效越来越感兴趣。我们对已发表的随机对照试验(RCT)证据进行了系统的元分析。从开始到 2020 年 6 月,我们在 MEDLINE/PubMed、PsycARTICLES 和 EMBASE 上搜索了 MBI(正念、气功、太极、瑜伽)作为附加治疗或单一疗法与无治疗、最小治疗以及被动和主动对照条件下的精神障碍患者的研究。使用评估系统评价的测量工具(AMSTAR)评估纳入的荟萃分析方法的质量,使用 AMSTAR-Plus 评估 RCT 的方法学质量。17 项荟萃分析中有 16 项(94%)具有良好的总体方法学质量。在内容效度方面,9 项荟萃分析(53%)被认为是良好的。在方法学质量良好(AMSTAR 8≤)和内容效度良好(AMSTAR+ 4≤)的荟萃分析中,正念疗法在精神分裂症和注意力缺陷多动障碍中的效果较大(0.80 或更高),正念疗法在创伤后应激障碍中的效果中等(0.50≤0.80),瑜伽疗法在精神分裂症中的效果较小(0.20<0.50)。没有报告严重不良事件(n RCTs=43,MBI 组 n=1774),而失访率与被动和主动对照条件相当。我们的元分析表明,正念,在较小程度上是瑜伽,可能是药物治疗和心理治疗的有效补充,并且可以作为精神障碍患者健康生活方式干预的补充。目前,气功和太极的纳入试验在方法学质量和内容效度方面缺乏高的荟萃分析证据。

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[3]
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[4]
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[5]
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