军事相关创伤后应激障碍与正念冥想：系统评价与荟萃分析。
Military-related posttraumatic stress disorder and mindfulness meditation: A systematic review and meta-analysis.
机构信息
Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China.
The Battalion 3 of Cadet Brigade, School of Basic Medicine, Naval Medical University, Shanghai, 200433, China.
出版信息
Chin J Traumatol. 2021 Jul;24(4):221-230. doi: 10.1016/j.cjtee.2021.05.003. Epub 2021 May 18.
PURPOSE
Posttraumatic stress disorder (PTSD) is a significant global mental health concern, especially in the military. This study aims to estimate the efficacy of mindfulness meditation in the treatment of military-related PTSD, by synthesizing evidences from randomized controlled trials.
METHODS
Five electronic databases (Pubmed, EBSCO Medline, Embase, PsychINFO and Cochrane Library) were searched for randomized controlled trials focusing on the treatment effect of mindfulness meditation on military-related PTSD. The selection of eligible studies was based on identical inclusion and exclusion criteria. Information about study characteristics, participant characteristics, intervention details, PTSD outcomes, as well as potential adverse effects was extracted from the included studies. Risk of bias of all the included studies was critically assessed using the Cochrane Collaboration's tool. R Statistical software was performed for data analysis.
RESULTS
A total of 1902 records were initially identified and screened. After duplicates removal and title & abstract review, finally, 19 articles in English language with 1326 participants were included through strict inclusion and exclusion criteria. The results revealed that mindfulness meditation had a significantly larger effect on alleviating military-related PTSD symptoms compared with control conditions, such as treatment as usual, present-centered group therapy and PTSD health education (standardized mean difference (SMD) = -0.33; 95% CI [-0.45, -0.21]; p < 0.0001). Mindfulness interventions with different control conditions (active or non-active control, SMD = -0.33, 95% CI [-0.46, -0.19]; SMD = -0.49, 95% CI [-0.88, -0.10], respectively), formats of delivery (group-based or individual-based, SMD = -0.30, 95% CI [-0.42, -0.17], SMD = -0.49, 95% CI [-0.90, -0.08], respectively) and intervention durations (short-term or standard duration, SMD = -0.27, 95% CI [-0.46, -0.08], SMD = -0.40, 95% CI [-0.58, -0.21], respectively) were equally effective in improving military-related PTSD symptoms.
CONCLUSION
Findings from this meta-analysis consolidate the efficacy and feasibility of mindfulness meditation in the treatment of military-related PTSD. Further evidence with higher quality and more rigorous design is needed in the future.
目的
创伤后应激障碍（PTSD）是一个重大的全球心理健康问题，尤其是在军队中。本研究旨在通过综合随机对照试验的证据，评估正念冥想在治疗与军事相关的 PTSD 方面的疗效。
方法
在五个电子数据库（PubMed、EBSCO Medline、Embase、PsychINFO 和 Cochrane Library）中搜索了专注于正念冥想对与军事相关的 PTSD 的治疗效果的随机对照试验。根据相同的纳入和排除标准选择合格的研究。从纳入的研究中提取研究特征、参与者特征、干预细节、PTSD 结局以及潜在不良反应的信息。使用 Cochrane 协作的工具对所有纳入研究的偏倚风险进行批判性评估。使用 R 统计软件进行数据分析。
结果
最初确定并筛选了 1902 条记录。经过重复记录去除和标题摘要审查后，最终通过严格的纳入和排除标准，确定了 19 篇英文文献，共纳入 1326 名参与者。结果表明，与对照条件（如常规治疗、以当下为中心的团体治疗和 PTSD 健康教育）相比，正念冥想对缓解与军事相关的 PTSD 症状有显著更大的效果（标准化均数差（SMD）=-0.33；95%CI[-0.45，-0.21]；p<0.0001）。具有不同对照条件（主动或非主动对照，SMD=-0.33，95%CI[-0.46，-0.19]；SMD=-0.49，95%CI[-0.88，-0.10]）、不同交付形式（基于团体或个体，SMD=-0.30，95%CI[-0.42，-0.17]；SMD=-0.49，95%CI[-0.90，-0.08]）和不同干预持续时间（短期或标准持续时间，SMD=-0.27，95%CI[-0.46，-0.08]；SMD=-0.40，95%CI[-0.58，-0.21]）的正念冥想干预同样有效改善与军事相关的 PTSD 症状。
结论
这项荟萃分析的结果证实了正念冥想在治疗与军事相关的 PTSD 方面的疗效和可行性。未来需要更高质量和更严格设计的证据。
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