University of Sheffield, UK.
Sheffield Health and Social Care NHS Foundation Trust, UK.
Br J Clin Psychol. 2021 Sep;60(3):375-399. doi: 10.1111/bjc.12288. Epub 2021 Apr 6.
This review sought to evaluate the effectiveness of the 'Stress Control' (SC) large psychoeducational 6-session group programme developed to increase access to treatment for patients with anxiety and depression.
Systematic review and meta-analysis (Prospero registration: CRD42020173676).
Pre-post and post-treatment follow-up effect sizes were extracted and synthesized in a random effects meta-analysis, and variations in effect sizes were investigated via moderator analyses. Secondary analyses synthesized between-group effect sizes from controlled studies containing comparator treatments and calculated the average dropout rate. The quality of the meta-analysis was assessed using the GRADE approach.
Nineteen studies with pre-post treatment outcomes were included. The average group size was N = 39, and the average dropout rate was 34%. Pooled effect sizes indicated moderate pre-post treatment reductions in anxiety (ES = 0.58; CI 0.41 to 0.75; N = 5597; Z = 7.13; p < .001), moderate reductions in depression (ES = 0.62; CI 0.44 to 0.80; N = 5538, Z = 7.30; p < .001), and large reductions in global distress (ES = 0.86; CI 0.61 to 1.11; N = 591; Z = 7.41; p < .001). At follow-up, improvements in anxiety, depression, and global distress were maintained. When SC was compared to active and passive controls, outcomes were equivalent for anxiety (ES = 0.12, 95% CI -0.25 to 0.49, Z = -0.70; p = .482) and depression (ES = 0.15, 95% CI -0.24 to 0.54, Z = 0.84; p = .401).
SC appears to be a clinically effective and durable low-intensity group intervention that facilitates access to treatment for large patient numbers. However, conclusions are limited by the low methodological quality of the evidence.
The stress control version of large group psychoeducation is appropriate and effective for mild-to-moderate anxiety and depression The evidence base for stress control is predominantly made up of practice-based studies Stress control needs to form one component of the overall offer made to patients presenting with mild-to-moderate anxiety and depression The competencies required to deliver such groups need better specification.
本综述旨在评估“压力控制”（SC）大型心理教育 6 节团体方案的有效性，该方案旨在增加焦虑和抑郁患者的治疗机会。
系统评价和荟萃分析（Prospero 注册：CRD42020173676）。
提取预-后和随访后的效应量，并在随机效应荟萃分析中进行综合，通过调节分析研究效应量的变化。对包含比较治疗的对照研究中的组间效应量进行二次分析，并计算平均辍学率。使用 GRADE 方法评估荟萃分析的质量。
纳入了 19 项具有预-后治疗结果的研究。平均组大小为 N=39，平均辍学率为 34%。汇总效应量表明，焦虑的预-后治疗有中度降低（ES=0.58；CI 0.41 至 0.75；N=5597；Z=7.13；p<.001），抑郁中度降低（ES=0.62；CI 0.44 至 0.80；N=5538，Z=7.30；p<.001），总体困扰有较大降低（ES=0.86；CI 0.61 至 1.11；N=591；Z=7.41；p<.001）。随访时，焦虑、抑郁和总体困扰的改善仍得以维持。当将 SC 与积极和消极对照进行比较时，焦虑（ES=0.12，95%CI-0.25 至 0.49，Z=-0.70；p=0.482）和抑郁（ES=0.15，95%CI-0.24 至 0.54，Z=0.84；p=0.401）的结果是等效的。
SC 似乎是一种临床有效的、持久的低强度团体干预措施，为大量患者提供了治疗机会。然而，由于证据的方法学质量较低，结论受到限制。
大组心理教育的压力控制版本适用于轻中度焦虑和抑郁患者压力控制是有效的压力控制的证据基础主要由实践基础研究组成压力控制需要成为向轻度至中度焦虑和抑郁患者提供的整体服务的一部分需要更好地规范提供此类团体所需的能力。
