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人际创伤后心理干预对青少年焦虑、抑郁、物质使用和 PTSD 症状的相对疗效:一项荟萃分析。

Relative efficacy of psychological interventions following interpersonal trauma on anxiety, depression, substance use, and PTSD symptoms in young people: A meta-analysis.

机构信息

Department of Research and Translation, Orygen, Parkville, Victoria, Australia.

Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

出版信息

Early Interv Psychiatry. 2022 Nov;16(11):1175-1184. doi: 10.1111/eip.13265. Epub 2022 Feb 1.

Abstract

AIM

Interpersonal trauma exposures are associated with anxiety, depression, and substance use in youth populations (aged 12-25 years). This meta-analysis reports on the efficacy of psychological interventions on these symptom domains in addition to post-traumatic stress.

METHODS

Following PRISMA guidelines, a search of electronic databases was performed for randomized controlled trials (RCTs) assessing interventions for young people following interpersonal trauma exposure. Risk of bias was assessed using the Cochrane Risk of Bias tool. Data were analysed using random-effects meta-analyses.

RESULTS

Of the 4832 records screened, 78 studies were reviewed, and 10 RCTs, involving 679 participants (mean age 15.6 years), were analysed. There was a large pooled effect size for post-traumatic stress (7 studies, g = 1.43, 95% CI [0.37, 2.15], p = .002) and substance use (2 studies, g = 0.70, 95% CI [-0.11, 1.22], p < .001) and small effect sizes for anxiety (4 studies, g = 0.30, 95% CI [0.10, 0.49], p = .003), and trend-level effect for depression (10 studies, g = 0.27, 95% CI [0.00, 0.54], p = .052). Heterogeneity was significant for post-traumatic stress and moderate for depression.

CONCLUSIONS

High-quality RCTs of psychological interventions for anxiety, depression, substance use, and post-traumatic stress symptoms in young people exposed to interpersonal trauma are scarce. While available studies show either statistically significant or trend-level efficacy for psychological interventions in reducing these symptoms, wide confidence intervals, heterogeneity and small sample size mean that results need to be interpreted with caution.

摘要

目的

人际创伤暴露与青少年(12-25 岁)的焦虑、抑郁和物质使用有关。本荟萃分析报告了心理干预对创伤后应激以外这些症状领域的疗效。

方法

根据 PRISMA 指南,对评估人际创伤后年轻人干预措施的随机对照试验(RCT)进行了电子数据库检索。使用 Cochrane 偏倚风险工具评估偏倚风险。使用随机效应荟萃分析对数据进行分析。

结果

在筛选的 4832 条记录中,共回顾了 78 项研究,分析了 10 项 RCT,涉及 679 名参与者(平均年龄 15.6 岁)。创伤后应激(7 项研究,g=1.43,95%CI [0.37, 2.15],p=0.002)和物质使用(2 项研究,g=0.70,95%CI [-0.11, 1.22],p<0.001)的合并效应量较大,焦虑(4 项研究,g=0.30,95%CI [0.10, 0.49],p=0.003)的效应量较小,抑郁(10 项研究,g=0.27,95%CI [0.00, 0.54],p=0.052)的效应量呈趋势。创伤后应激的异质性显著,抑郁的异质性为中度。

结论

人际创伤后青少年焦虑、抑郁、物质使用和创伤后应激症状的高质量 RCT 很少。虽然现有研究表明,心理干预在减轻这些症状方面具有统计学意义或趋势水平的疗效,但宽置信区间、异质性和小样本量意味着结果需要谨慎解释。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1779/9786735/35b9550c3a64/EIP-16-1175-g001.jpg

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