Northeast Addiction and Mental Health Centre for Holistic Recovery, Calgary, Alberta, Canada.
Northeast Addiction and Mental Health Centre for Holistic Recovery, Calgary, Alberta, Canada
Fam Med Community Health. 2022 Mar;10(1). doi: 10.1136/fmch-2021-001154.
Journaling is a common non-pharmacological tool in the management of mental illness, however, no clear evidence-based guideline exists informing primary care providers on its use. We seek here to present this synthesis that may begin to inform future research and eventual evidence-based guideline development.
Of the 3797 articles retrieved from MEDLINE, EMBASE, PsycINFO, 20 peer-reviewed randomised control trials (31 outcomes) met inclusion criteria. These studies addressed the impact of a journaling intervention on PTSD, other anxiety disorders, depression or a combination of the aforementioned.
Peer reviewed, randomised control trials on the impact of journaling on mental illness were included.
MEDLINE, EMBASE and PsycINFO.
The data are highly heterogeneous (control arm=I of 71.2%, intervention arm=I of 83.8%) combined with a B-level Strength of Recommendation Taxonomy recommendation. It was additionally found that there is a significant pre-post psychometric scale difference between control (-0.01, 95% CI -0.03 to 0.00) and intervention arms (-0.06, 95% CI -0.09 to -0.03). This 5% difference between groups indicates that a journaling intervention resulted in a greater reduction in scores on patient health measures. Cohen's d effect size analysis of studies suggests a small to moderate benefit.
Further studies are needed to better define the outcomes. Our review suggests that while there is some randomised control data to support the benefit of journaling, high degrees of heterogeneity and methodological flaws limit our ability to definitively draw conclusions about the benefit and effect size of journaling in a wide array of mental illnesses. Given the low risk of adverse effects, low resource requirement and emphasis on self-efficacy, primary care providers should consider this as an adjunct therapy to complement current evidence-based management.
在精神疾病的管理中，记日志是一种常见的非药物工具，但没有明确的基于证据的指南来告知初级保健提供者如何使用它。我们在这里旨在提出这一综合建议，以期为未来的研究和最终的基于证据的指南制定提供信息。
从 MEDLINE、EMBASE 和 PsycINFO 中检索到的 3797 篇文章中，有 20 项同行评议的随机对照试验（31 项结果）符合纳入标准。这些研究探讨了记日志干预对创伤后应激障碍、其他焦虑障碍、抑郁或上述疾病组合的影响。
纳入了关于记日志对精神疾病影响的同行评审、随机对照试验。
MEDLINE、EMBASE 和 PsycINFO。
数据高度异质（对照组 I 为 71.2%，干预组 I 为 83.8%），结合 B 级推荐强度分类建议。此外，还发现对照组（-0.01，95%置信区间-0.03 至 0.00）和干预组（-0.06，95%置信区间-0.09 至-0.03）之间的心理测量量表存在显著的前后差异。两组之间 5%的差异表明，记日志干预导致患者健康测量评分的降低幅度更大。对研究进行 Cohen's d 效应大小分析表明，这具有较小到中等的益处。
需要进一步的研究来更好地定义结果。我们的综述表明，虽然有一些随机对照数据支持记日志的益处，但高度的异质性和方法学缺陷限制了我们对记日志在广泛的精神疾病中的益处和效果大小做出明确结论的能力。鉴于不良反应风险低、资源需求低且强调自我效能，初级保健提供者应将其视为补充当前基于证据的管理的辅助治疗方法。
