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基于互联网和移动设备的性功能障碍心理干预:系统评价与荟萃分析

Internet- and mobile-based psychological interventions for sexual dysfunctions: a systematic review and meta-analysis.

作者信息

Zarski Anna-Carlotta, Velten Julia, Knauer Johannes, Berking Matthias, Ebert David Daniel

机构信息

Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Professorship Psychology and Digital Mental Health Care, Department of Sport and Health Sciences, Technical University Munich, Munich, Germany.

出版信息

NPJ Digit Med. 2022 Sep 9;5(1):139. doi: 10.1038/s41746-022-00670-1.

Abstract

Sexual dysfunctions are highly prevalent and undertreated. Internet- and mobile-based psychological interventions (IMIs) could be a promising addition to close this treatment gap, given their accessibility, anonymity, and scalability. This systematic review and meta-analysis investigated the efficacy of IMIs for sexual dysfunctions. A comprehensive literature search was conducted in August 2021 on randomized controlled trials investigating the effects of IMIs on sexual functioning and satisfaction compared to a control condition. Twelve RCTs with 14 comparisons were reviewed with six IMIs targeting female and six IMIs targeting male sexual dysfunctions and n = 952 participants were evaluated in the meta-analysis. IMIs were significantly more effective than control conditions (k = 11 waitlist control group, k = 3 online discussion board) at post-treatment for female sexual functioning (g = 0.59, CI: 0.28-0.90, I= 0%) and satisfaction (g = 0.90, CI: 0.02-1.79, I= 82%), and male sexual functioning (g = 0.18, CI: 0.02-0.34, I= 0%). No significant effect was found for male sexual satisfaction (g = 0.69, CI: -0.13-1.51, I= 88%) with substantial heterogeneity in studies. Most studies showed high dropout, with ten studies indicating some concern of risk of bias, and two studies showing high risk of bias. The results suggest that IMIs can be an effective treatment for sexual dysfunctions, although additional high-quality research is needed. Given the limited availability of specialized treatment for sexual dysfunctions and individual preferences for discrete treatment options, IMIs seem to be a valuable addition to routine care, empowering individuals to promote their sexual health on a guided self-help basis.

摘要

性功能障碍非常普遍且治疗不足。基于互联网和移动设备的心理干预(IMIs)因其可及性、匿名性和可扩展性,可能是填补这一治疗差距的有前景的补充手段。本系统评价和荟萃分析调查了IMIs对性功能障碍的疗效。2021年8月对随机对照试验进行了全面的文献检索,这些试验研究了与对照条件相比,IMIs对性功能和满意度的影响。对12项随机对照试验进行了综述,有14项比较,其中6项IMIs针对女性性功能障碍,6项IMIs针对男性性功能障碍,荟萃分析评估了n = 952名参与者。在治疗后,IMIs在改善女性性功能(g = 0.59,CI:0.28 - 0.90,I = 0%)和满意度(g = 0.90,CI:0.02 - 1.79,I = 82%)以及男性性功能(g = 0.18,CI:0.02 - 0.34,I = 0%)方面显著比对照条件更有效。对于男性性满意度(g = 0.69,CI:-0.13 - 1.51,I = 88%)未发现显著效果,各研究存在实质性异质性。大多数研究显示高失访率,10项研究表明存在一些偏倚风险问题,2项研究显示高偏倚风险。结果表明,IMIs可以是性功能障碍的一种有效治疗方法,尽管还需要更多高质量研究。鉴于性功能障碍专门治疗的可及性有限以及个体对不同治疗选择的偏好,IMIs似乎是常规护理中有价值的补充,使个体能够在有指导的自助基础上促进自身性健康。

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