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心理干预在常规实践中的有效性:系统评价和荟萃分析。

The Effectiveness of Psychological Interventions Delivered in Routine Practice: Systematic Review and Meta-analysis.

机构信息

University of Sheffield, Sheffield, UK.

Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK.

出版信息

Adm Policy Ment Health. 2023 Jan;50(1):43-57. doi: 10.1007/s10488-022-01225-y. Epub 2022 Oct 6.

Abstract

This review presents a comprehensive evaluation of the effectiveness of routinely delivered psychological therapies across inpatient, outpatient and University-based clinics. This was a pre-registered systematic-review of studies meeting pre-specified inclusion criteria (CRD42020175235). Eligible studies were searched in three databases: MEDLINE, CINAHL and PsycInfo. Pre-post treatment (uncontrolled) effect sizes were calculated and pooled using random effects meta-analysis to generate effectiveness benchmarks. Moderator analyses were used to examine sources of heterogeneity in effect sizes. Overall, 252 studies (k = 298 samples) were identified, of which 223 (k = 263 samples) provided sufficient data for inclusion in meta-analysis. Results showed large pre-post treatment effects for depression [d = 0.96, (CI 0.88-1.04), p ≤ 0.001, k = 122], anxiety [d = 0.8 (CI 0.71-0.9), p ≤ 0.001, k = 69], and other outcomes [d = 1.01 (CI 0.93-1.09), p ≤ 0.001, k = 158]. This review provides support for the effectiveness of routinely delivered psychological therapy. Effectiveness benchmarks are supplied to support service evaluations across multiple settings.

摘要

本综述全面评估了在住院、门诊和大学诊所常规提供的心理治疗的效果。这是一项符合预先指定纳入标准(CRD42020175235)的预先注册的系统综述。在三个数据库中搜索了符合条件的研究:MEDLINE、CINAHL 和 PsycInfo。使用随机效应荟萃分析计算并汇总了治疗前后(非对照)的效应量,以生成有效性基准。使用调节分析来检查效应量中异质性的来源。总共确定了 252 项研究(k=298 个样本),其中 223 项(k=263 个样本)提供了足够的数据进行荟萃分析。结果表明,抑郁[d=0.96(CI 0.88-1.04),p≤0.001,k=122]、焦虑[d=0.8(CI 0.71-0.9),p≤0.001,k=69]和其他结局[d=1.01(CI 0.93-1.09),p≤0.001,k=158]的治疗前后效应较大。本综述为常规提供的心理治疗的有效性提供了支持。提供有效性基准以支持多个环境下的服务评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c539/9832112/d25c367bd26e/10488_2022_1225_Fig1_HTML.jpg

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