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新冠病毒和其他冠状病毒感染后的心理健康干预措施:当前建议的系统评价和随机对照试验的荟萃分析。

Mental health interventions following COVID-19 and other coronavirus infections: a systematic review of current recommendations and meta-analysis of randomized controlled trials.

机构信息

Departamento de Psiquiatria, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.

出版信息

Braz J Psychiatry. 2021 Nov-Dec;43(6):665-678. doi: 10.1590/1516-4446-2020-1582.

Abstract

OBJECTIVE

To review the most common mental health strategies aimed at alleviating and/or preventing mental health problems in individuals during the coronavirus disease 2019 (COVID-19) and other coronavirus pandemics.

METHODS

We conducted a systematic review of the literature assessing three databases (PubMed, SCOPUS, and PsycINFO). A meta-analysis was performed with data from randomized controlled trials (RCTs). For non-RCT studies, a critical description of recommendations was performed.

RESULTS

From a total of 2,825 articles, 125 were included. Of those, three RCTs were included in the meta-analysis. The meta-analysis revealed that the interventions promoted better overall mental health outcomes as compared to control groups (standardized mean difference [SMD] = 0.87 [95%CI 0.33-1.41], p < 0.001, I2 = 69.2%), but did not specifically improve anxiety (SMD = 0.98 [95%CI -0.17 to 2.13], p > 0.05; I2 = 36.8%). Concerning the systematic review, we found a large body of scientific literature proposing recommendations involving psychological/psychiatric interventions, self-care, education, governmental programs, and the use of technology and media.

CONCLUSIONS

We found a large body of expert recommendations that may help health practitioners, institutional and governmental leaders, and the general population cope with mental health issues during a pandemic or a crisis period. However, most articles had a low level of evidence, stressing the need for more studies with better design (especially RCTs) investigating potential mental health interventions during COVID-19.

PROSPERO REGISTRATION

CRD42020190212.

摘要

目的

综述针对新型冠状病毒病(COVID-19)和其他冠状病毒大流行期间个体缓解和/或预防心理健康问题的最常见心理健康策略。

方法

我们对评估三个数据库(PubMed、SCOPUS 和 PsycINFO)的文献进行了系统综述。对随机对照试验(RCT)的数据进行了荟萃分析。对于非 RCT 研究,对建议进行了批判性描述。

结果

从总共 2825 篇文章中,纳入了 125 篇。其中,有 3 项 RCT 纳入荟萃分析。荟萃分析显示,与对照组相比,干预措施促进了更好的整体心理健康结果(标准化均数差 [SMD] = 0.87 [95%CI 0.33-1.41],p < 0.001,I2 = 69.2%),但并未专门改善焦虑(SMD = 0.98 [95%CI -0.17 至 2.13],p > 0.05;I2 = 36.8%)。关于系统综述,我们发现大量科学文献提出了涉及心理/精神病学干预、自我保健、教育、政府计划以及使用技术和媒体的建议。

结论

我们发现大量专家建议可能有助于卫生保健从业者、机构和政府领导以及普通大众在大流行或危机期间应对心理健康问题。然而,大多数文章的证据水平较低,强调需要更多具有更好设计(特别是 RCT)的研究来调查 COVID-19 期间潜在的心理健康干预措施。

PROSPERO 注册号:CRD42020190212。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0024/8639008/f948075089f3/bjp-43-06-665-g001.jpg

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