Tang Rong, Yang Junlan, Yu Yanmei, Fang Yuying
Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.
Shandong Provincial Hospital, Jinan, China.
Front Psychol. 2022 Oct 26;13:796594. doi: 10.3389/fpsyg.2022.796594. eCollection 2022.
Cognitive behavioral therapy (CBT) has well-characterized benefits in alleviating diseases associated with depression, anxiety, and obesity, resulting in a marked improvement in the patient's quality of life. There are some studies regarding the effects of CBT on patients with polycystic ovary syndrome (PCOS). However, there is still no report of a meta-analysis for systematic assessment.
This study aimed to evaluate the effectiveness of CBT in improving weight loss, anxiety, depression, life quality, compliance, and pregnancy outcomes in patients with PCOS.
Studies regarding CBT related to PCOS in PubMed, Cochrane library, Embase, ClinicalTrials.gov, CNKI, and WANFANG DATA were searched for up to 19 November 2020. A random-effects model was used to perform a meta-analysis.
Eight trials regarding CBT compared with lifestyle modification and routine treatments were included. No differences in depression (SMD -1.11; 95% CI -2.28, 0.07; > 0.05), body mass index (BMI) (SMD 0.88; 95% CI -0.94, 2.71; > 0.05), or overall life quality (SMD 1.24; 95% CI -0.44, 2.92; > 0.05) were evident between CBT and control groups; however, anxiety (SMD -1.12; 95% CI -2.1, -0.13; < 0.05) and quality of life in hirsutism (SMD 0.92; 95% CI 0.48, 1.35; < 0.05) were significantly improved. For secondary outcomes, both patient compliance and pregnancy rate were improved, but no significant change in pregnancy loss rate was identified.
CBT exhibited obvious advantages in the alleviation of anxiety, improvement of quality of life in hirsutism, and increase of compliance and pregnancy rate in patients with PCOS. Larger and higher-quality randomized controlled trials are needed to clarify the role of CBT in PCOS.
[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021225856].
认知行为疗法(CBT)在缓解与抑郁、焦虑和肥胖相关的疾病方面具有明确的益处,可显著改善患者的生活质量。有一些关于CBT对多囊卵巢综合征(PCOS)患者影响的研究。然而,尚无进行系统评估的荟萃分析报告。
本研究旨在评估CBT对改善PCOS患者体重减轻、焦虑、抑郁、生活质量、依从性和妊娠结局的有效性。
检索了截至2020年11月19日在PubMed、Cochrane图书馆、Embase、ClinicalTrials.gov、中国知网和万方数据中与PCOS相关的CBT研究。采用随机效应模型进行荟萃分析。
纳入了八项关于CBT与生活方式改变及常规治疗比较的试验。CBT组与对照组在抑郁(标准化均数差[SMD] -1.11;95%置信区间[CI] -2.28,0.07;P>0.05)、体重指数(BMI)(SMD 0.88;95% CI -0.94,2.71;P>0.05)或总体生活质量(SMD 1.24;95% CI -0.44,2.92;P>0.05)方面无明显差异;然而,焦虑(SMD -1.12;95% CI -2.1,-0.13;P<0.05)和多毛症患者的生活质量(SMD 0.92;95% CI 0.48,1.35;P<0.05)有显著改善。对于次要结局,患者依从性和妊娠率均有所提高,但妊娠丢失率无显著变化。
CBT在缓解PCOS患者焦虑、改善多毛症患者生活质量以及提高依从性和妊娠率方面具有明显优势。需要开展更大规模、更高质量的随机对照试验来阐明CBT在PCOS中的作用。