Lam Jeffrey, Aftab Awais, Lee Ellen, Jeste Dilip
Warren Alpert Medical School, Brown University, Providence, Rhode Island.
Department of Psychiatry, Case Western Reserve University, Cleveland OH.
Curr Treat Options Psychiatry. 2020 Dec;7(4):471-488. doi: 10.1007/s40501-020-00228-6. Epub 2020 Aug 29.
Positive psychiatry shifts the focus of geriatric mental healthcare beyond studying disorders and psychopathology to studying factors that contribute to mental well-being and successful aging. An increasing number of interventional studies are using treatments that target modifiable positive psychosocial characteristics (PPCs) and study their impact on mental health. Here we provide an overview of the literature on positive psychiatry interventions using illustrative examples of interventions targeting social connectedness, meaning in life, wisdom, and resilience.
There is growing evidence that PPCs are modifiable constructs that may be associated with improved well-being, physical health, and mental health outcomes.
The preliminary evidence summarized in this narrative review indicates that positive psychiatry interventions targeting social connectedness, meaning in life, wisdom, and resilience can improve overall well-being and other positive health outcomes amongst older adults. The effect sizes of these interventions reported in RCTs and meta-analyses are typically small to medium, but occasionally large effect sizes are also reported. Current literature is restricted by heterogeneous methodology, limiting clinicians' abilities to extrapolate these principles of positive psychiatry into everyday practice. With the expanding body of evidence, positive psychiatry may have the potential to transform the landscape of geriatric mental health.
积极精神病学将老年精神卫生保健的重点从研究疾病和精神病理学转移到研究有助于心理健康和成功老龄化的因素。越来越多的干预性研究正在使用针对可改变的积极心理社会特征(PPCs)的治疗方法,并研究其对心理健康的影响。在此,我们以针对社会联系、生活意义、智慧和恢复力的干预措施为例,概述有关积极精神病学干预措施的文献。
越来越多的证据表明,PPCs是可改变的结构,可能与幸福感、身体健康和心理健康结果的改善相关。
本叙述性综述总结的初步证据表明,针对社会联系、生活意义、智慧和恢复力的积极精神病学干预措施可以改善老年人的整体幸福感和其他积极健康结果。随机对照试验(RCTs)和荟萃分析中报告的这些干预措施的效应大小通常为小到中等,但偶尔也会报告大的效应大小。当前的文献受到方法异质性的限制,限制了临床医生将这些积极精神病学原则推广到日常实践中的能力。随着证据的不断增加,积极精神病学可能有潜力改变老年精神卫生的格局。