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干预针对共病抑郁和超重/肥胖:系统评价。

Interventions targeting comorbid depression and overweight/obesity: A systematic review.

机构信息

Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China.

Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China.

出版信息

J Affect Disord. 2022 Oct 1;314:222-232. doi: 10.1016/j.jad.2022.07.027. Epub 2022 Jul 22.

Abstract

BACKGROUND

Overweight/obesity and depression are highly co-occurring conditions with shared pathophysiology as well as social and economic determinants. To our knowledge, this is the first systematic review aims to comprehensively synthesize extant literature with a focus on the effectiveness of interventions targeting obesity and depression comorbidity.

METHODS

We searched databases including MEDLINE, ProQuest Central, Web of Science, PsycINFO, Cochrane Library, from inception of the databases until Nov 12, 2021. Articles were included if they reported on the effects of pharmacological, psychological or dietary interventions on comorbid depression and overweight/obesity as their primary or secondary outcome.

RESULTS

Of the 5480 identified records, 19 eligible researches comprising 15 RCTs and 4 uncontrolled longitudinal studies for 3408 participants with comorbid depression and overweight/obesity. The available literature is not sufficient to inform evidence-based treatments targeting obesity and comorbid depression contemporaneously. Notwithstanding, the combination of CBT and lifestyle intervention show efficacy targeting obesity and comorbid depression as do some nutritional supplements, antidepressants and anti-diabetic agents.

LIMITATIONS

The high heterogeneity of various interventions in the included studies may cause a lack of comparability between different studies.

CONCLUSIONS

Concurrent management of depression and overweight/obesity is suggested by available data. There is a pressing need for studies that evaluate the effectiveness in real world samples of persons experiencing multiple co-occurring chronic diseases including but not limited to depression and overweight/obesity.

摘要

背景

超重/肥胖和抑郁症是高度共病的,具有共同的病理生理学以及社会和经济决定因素。据我们所知,这是第一项旨在全面综合现有文献的系统评价,重点关注针对肥胖和抑郁共病的干预措施的有效性。

方法

我们检索了数据库,包括 MEDLINE、ProQuest Central、Web of Science、PsycINFO、Cochrane Library,从数据库创建到 2021 年 11 月 12 日。如果文章报告了药物治疗、心理或饮食干预对共病抑郁和超重/肥胖的影响作为其主要或次要结局,则将其纳入。

结果

在 5480 条鉴定记录中,有 19 项符合条件的研究包括 15 项 RCT 和 4 项无对照纵向研究,涉及 3408 名共病抑郁和超重/肥胖的参与者。现有文献不足以提供针对肥胖和共病抑郁的循证治疗方法。尽管如此,CBT 和生活方式干预的结合针对肥胖和共病抑郁具有疗效,一些营养补充剂、抗抑郁药和抗糖尿病药物也是如此。

局限性

纳入研究中各种干预措施的高度异质性可能导致不同研究之间缺乏可比性。

结论

现有数据表明,应同时管理抑郁和超重/肥胖。迫切需要评估在经历多种共病慢性疾病(包括但不限于抑郁和超重/肥胖)的人群中,实际样本中各种干预措施的有效性的研究。

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