系统评价与荟萃分析：情绪失调青少年的自主神经功能改变。

Systematic Review and Meta-Analysis: Altered Autonomic Functioning in Youths With Emotional Dysregulation.

机构信息

University of Nottingham Malaysia, Malaysia; King's College London, United Kingdom.

IRCCS Stella Maris Foundation, Pisa, Italy; University of Pisa, Italy.

出版信息

J Am Acad Child Adolesc Psychiatry. 2024 Feb;63(2):216-230. doi: 10.1016/j.jaac.2023.01.017. Epub 2023 Feb 23.

DOI:10.1016/j.jaac.2023.01.017

PMID:36841327

Abstract

OBJECTIVE

To systematically investigate if there is a significant association between markers of autonomic functioning and emotional dysregulation (ED) in children and adolescents.

METHOD

Based on a preregistered protocol (PROSPERO: CRD42021239635), PubMed, Web of Knowledge/Science, Ovid MEDLINE, Embase, and APA PsycInfo databases were searched until April 21, 2021, to identify empirical studies reporting indices of autonomic nervous system (ANS) functioning in youths meeting DSM (version III, IV, IV-TR, 5 or 5-TR) or International Classification of Diseases (ICD) (version 9 or 10) criteria for any psychopathological/neurodevelopmental condition and assessed for ED with a validated scale. Eligible outcomes included correlation coefficients between ED and ANS measures or differences in ANS measures between youths with and without ED. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS) and the Newcastle-Ottawa Scale (NOS) for cohort studies. Random-effects meta-analyses were used for data synthesis.

RESULTS

There were 12 studies (1,016 participants) included in the descriptive review and 9 studies (567 participants) included in the meta-analyses. No evidence of a significant association between ED and altered cardiac or electrodermal functioning was found. However, exploratory meta-regressions suggested a possible association between reduced resting-state cardiac vagal control and increased ED.

CONCLUSION

This study did not find evidence of an association between ED and autonomic dysfunction. However, preliminary evidence that reduced vagal control at rest might be a transdiagnostic marker of ED in young people was found. Additional studies comparing autonomic measures in youths with and without ED are needed and should also assess the effects of interventions for ED on ANS functioning.

STUDY PREREGISTRATION INFORMATION

Systematic Review and Meta-Analysis: Is Autonomic Nervous System Functioning Atypical in Children and Adolescents With Emotional Dysregulation? https://www.crd.york.ac.uk/prospero/; CRD42021239635.

摘要

目的

系统调查儿童和青少年的自主功能标志物与情绪失调（ED）之间是否存在显著关联。

方法

根据预先注册的方案（PROSPERO：CRD42021239635），检索 PubMed、Web of Knowledge/Science、Ovid MEDLINE、Embase 和 APA PsycInfo 数据库，截至 2021 年 4 月 21 日，以确定报告符合 DSM（第 III、IV、IV-TR、5 或 5-TR 版）或国际疾病分类（ICD）（第 9 或 10 版）标准的任何精神病理学/神经发育状况的青少年自主神经系统（ANS）功能指标的实证研究，并使用经过验证的量表评估 ED。合格的结果包括 ED 与 ANS 测量之间的相关系数或 ED 青少年与无 ED 青少年之间 ANS 测量的差异。使用横断面研究评估工具（AXIS）和队列研究的纽卡斯尔-渥太华量表（NOS）评估研究质量。使用随机效应荟萃分析进行数据综合。