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焦虑、抑郁与生活质量:来自纵向观察研究证据的系统综述。

Anxiety, Depression and Quality of Life-A Systematic Review of Evidence from Longitudinal Observational Studies.

机构信息

Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.

出版信息

Int J Environ Res Public Health. 2021 Nov 16;18(22):12022. doi: 10.3390/ijerph182212022.

Abstract

This review aimed to systematically review observational studies investigating the longitudinal association between anxiety, depression and quality of life (QoL). A systematic search of five electronic databases (PubMed, PsycINFO, PSYNDEX, NHS EED and EconLit) as well as forward/backward reference searches were conducted to identify observational studies on the longitudinal association between anxiety, depression and QoL. Studies were synthesized narratively. Additionally, a random-effects meta-analysis was performed using studies applying the mental and physical summary scores (MCS, PCS) of the Short Form Health Survey. The review was prospectively registered with PROSPERO and a study protocol was published. = 47 studies on heterogeneous research questions were included, with sample sizes ranging from = 28 to 43,093. Narrative synthesis indicated that QoL was reduced before disorder onset, dropped further during the disorder and improved with remission. Before onset and after remission, QoL was lower in comparison to healthy comparisons. = 8 studies were included in random-effects meta-analyses. The pooled estimates of QoL at follow-up (FU) were of small to large effect sizes and showed that QoL at FU differed by disorder status at baseline as well as by disorder course over time. Disorder course groups differed in their MCS scores at baseline. Effect sizes were generally larger for MCS relative to PCS. The results highlight the relevance of preventive measures and treatment. Future research should consider individual QoL domains, individual anxiety/depressive disorders as well as the course of both over time to allow more differentiated statements in a meta-analysis.

摘要

本综述旨在系统地回顾观察性研究,以调查焦虑、抑郁与生活质量(QoL)之间的纵向关联。通过对五个电子数据库(PubMed、PsycINFO、PSYNDEX、NHS EED 和 EconLit)进行系统搜索,并进行前瞻性注册,以识别关于焦虑、抑郁和 QoL 之间纵向关联的观察性研究。此外,还对应用简明健康调查量表的心理和生理综合评分(MCS、PCS)的研究进行了随机效应荟萃分析,并发布了研究方案。共纳入了 47 项研究,这些研究具有不同的研究问题,样本量从 28 到 43093 不等。叙事综合表明,在发病前 QoL 降低,在发病期间进一步下降,在缓解后有所改善。在发病前和缓解后,QoL 均低于健康对照组。纳入了 8 项随机效应荟萃分析研究。随访(FU)时 QoL 的汇总估计值具有从小到中等的效应量大小,表明 FU 时 QoL 不仅与基线时的疾病状态有关,而且与随时间推移的疾病进程有关。疾病进程组在基线时的 MCS 评分存在差异。与 PCS 相比,MCS 的效应量通常更大。研究结果强调了预防措施和治疗的重要性。未来的研究应考虑个体的 QoL 领域、个体的焦虑/抑郁障碍以及两者随时间的变化过程,以便在荟萃分析中做出更具区分度的结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4f4/8621394/261896a670a1/ijerph-18-12022-g001.jpg

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