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Meta 分析住院环境下心疗的效果:诊断和治疗方法的调节作用探讨

Meta-Analysis of the Effect of Psychotherapy in an Inpatient Setting: Examining the Moderating Role of Diagnosis and Therapeutic Approach.

出版信息

Psychiatry. 2022 Winter;85(4):399-417. doi: 10.1080/00332747.2022.2062660. Epub 2022 Apr 20.

Abstract

OBJECTIVE

The current meta-analysis investigates the efficacy of psychotherapy during psychiatric hospitalization and examines the moderating role of diagnosis and therapeutic approach.

METHODS

We conducted systematic searches in literature databases, including PubMed, PsycInfo, and Google Scholar. In total, 37 samples were included for the meta-analysis with a total of 4,443 patients. The primary outcome was the standardized mean differences in clinical status measured by symptomatic and functional measures.

RESULTS

The meta-analysis of 22 samples without a control group resulted in the upper end of the medium effect size for the overall effect of treatment during psychiatric hospitalization that included psychotherapy (k = 22, Cohen's d = 0.70, and 95% Cl 0.36 to 1.04). The meta-analysis of 15 samples with a control group resulted in the upper end of the low effect size for the contribution of psychotherapy to the improvement of patients' clinical status measured by symptomatic and functional measures (k = 15, Cohen's d = 0.43, and 95% CI 0.06 to 0.81). No significant effects were uncovered for psychotherapy orientation. Diagnosis was found to moderate the contribution of psychotherapy in an inpatient setting to the improvement of patients' clinical condition.

CONCLUSION

Psychotherapy during psychiatric hospitalization may be an effective treatment. Across the various samples, psychotherapy has a moderate effect on the reduction of psychiatric symptoms beyond the overall effect of ward treatment.

摘要

目的

本荟萃分析旨在考察精神科住院期间心理治疗的疗效,并探讨诊断和治疗方法的调节作用。

方法

我们在文献数据库(包括 PubMed、PsycInfo 和 Google Scholar)中进行了系统检索。共有 37 个样本被纳入荟萃分析,共有 4443 名患者。主要结局是通过症状和功能测量衡量的临床状况的标准化均数差值。

结果

22 个无对照组的样本的荟萃分析结果显示,包括心理治疗在内的精神科住院期间治疗的总体效果具有中上的中等效应大小(k=22,Cohen's d=0.70,95%CI 0.36 至 1.04)。15 个有对照组的样本的荟萃分析结果显示,心理治疗对症状和功能测量衡量的患者临床状况改善的贡献具有中上的低效应大小(k=15,Cohen's d=0.43,95%CI 0.06 至 0.81)。心理治疗方向未显示出显著效果。诊断被发现可调节心理治疗在住院环境中对改善患者临床状况的贡献。

结论

精神科住院期间的心理治疗可能是一种有效的治疗方法。在各种样本中,心理治疗对减轻精神症状的效果除了病房治疗的总体效果之外,还有中等效果。

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