Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
Gen Hosp Psychiatry. 2022 Jul-Aug;77:40-68. doi: 10.1016/j.genhosppsych.2022.04.002. Epub 2022 Apr 9.
We evaluated the effects of mental health interventions among people hospitalized with COVID-19.
We conducted a systematic review and searched 9 databases (2 Chinese-language) from December 31, 2019 to June 28, 2021. Eligible randomized controlled trials assessed interventions among hospitalized COVID-19 patients that targeted mental health symptoms. Due to the poor quality of trials, we sought to verify accuracy of trial reports including results.
We identified 47 randomized controlled trials from China (N = 42), Iran (N = 4) and Turkey (N = 1) of which 21 tested the efficacy of psychological interventions, 5 physical and breathing exercises, and 21 a combination of interventions. Trial information could only be verified for 3 trials of psychological interventions (cognitive behavioral, guided imagery, multicomponent online), and these were the only trials with low risk of bias on at least 4 of 7 domains. Results could not be pooled or interpreted with confidence due to the degree of poor reporting and trial quality, the frequency of what were deemed implausibly large effects, and heterogeneity.
Trials of interventions to address mental health in hospitalized COVID-19 patients, collectively, are not of sufficient quality to inform practice. Health care providers should refer to existing expert recommendations and standard hospital-based practices.
PROSPERO (CRD42020179703); registered on April 17, 2020.
评估针对 COVID-19 住院患者的心理健康干预措施的效果。
我们进行了系统评价，并于 2019 年 12 月 31 日至 2021 年 6 月 28 日检索了 9 个数据库（包括 2 个中文数据库）。合格的随机对照试验评估了针对 COVID-19 住院患者心理健康症状的干预措施。由于试验质量较差，我们试图验证试验报告的准确性，包括结果。
我们从中国（N=42）、伊朗（N=4）和土耳其（N=1）的 47 项随机对照试验中确定了 21 项心理干预试验、5 项身体和呼吸练习以及 21 项干预措施的组合。仅对 3 项心理干预试验（认知行为、引导意象、多组分在线）的试验信息进行了验证，这些试验在至少 7 个领域中的 4 个领域具有低偏倚风险。由于报告质量差和试验质量差、被认为效果不真实的频率以及异质性，结果无法进行汇总或有信心地解释。
针对 COVID-19 住院患者心理健康的干预措施试验总体质量不足，无法为实践提供信息。医疗保健提供者应参考现有的专家建议和标准的基于医院的实践。
PROSPERO（CRD42020179703）；于 2020 年 4 月 17 日登记。
