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以家庭为中心的围产期抑郁症干预措施的效果:系统评价概述

Effect of family-centered interventions for perinatal depression: an overview of systematic reviews.

作者信息

He Liping, Soh Kim Lam, Yu Jiaxiang, Chen Aixiang, Dong Xiujuan

机构信息

Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.

Department of Nursing, Chang Zhi Medical College, Changzhi, Shanxi, China.

出版信息

Front Psychiatry. 2023 Jun 1;14:1094360. doi: 10.3389/fpsyt.2023.1094360. eCollection 2023.

Abstract

OBJECTIVE

This study aimed to evaluate and conclude the quality of critically systematic reviews (SRs) of the efficacy of family-centered interventions on perinatal depression.

METHODS

SRs of the efficacy of family-centered interventions on perinatal depression were systematically searched in nine databases. The retrieval period was from the inception of the database to December 31, 2022. In addition, two reviewers conducted an independent evaluation of the quality of reporting, bias risk, methodologies, and evidence using ROBIS (an instrument for evaluating the bias risk of SRs), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), AMSTAR 2 (an assessment tool for SRs), and grading of recommendations, assessment, development and evaluations (GRADE).

RESULTS

A total of eight papers satisfied the inclusion criteria. In particular, AMSTAR 2 rated five SRs as extremely low quality and three SRs as low quality. ROBIS graded four out of eight SRs as "low risk." Regarding PRISMA, four of the eight SRs were rated over 50%. Based on the GRADE tool, two out of six SRs rated maternal depressive symptoms as "moderate;" one out of five SRs rated paternal depressive symptoms as "moderate;" one out of six SRs estimated family functioning as "moderate," and the other evidence was rated as "very low" or "low." Of the eight SRs, six (75%) reported that maternal depressive symptoms were significantly reduced, and two SRs (25%) were not reported.

CONCLUSION

Family-centered interventions may improve maternal depressive symptoms and family function, but not paternal depressive symptoms. However, the quality of methodologies, evidence, reporting, and bias of risk in the included SRs of family-centered interventions for perinatal depression was not satisfactory. The above-mentioned demerits may negatively affect SRs and then cause inconsistent outcomes. Therefore, SRs with a low risk of bias, high-quality evidence, standard reporting, and strict methodology are necessary to provide evidence of the efficacy of family-centered interventions for perinatal depression.

摘要

目的

本研究旨在评估并总结以家庭为中心的干预措施对围产期抑郁症疗效的批判性系统评价(SRs)的质量。

方法

在九个数据库中系统检索以家庭为中心的干预措施对围产期抑郁症疗效的系统评价。检索期从各数据库建库至2022年12月31日。此外,两名评审员使用ROBIS(一种评估系统评价偏倚风险的工具)、系统评价和Meta分析的首选报告项目(PRISMA)、AMSTAR 2(一种系统评价评估工具)以及推荐分级、评估、制定与评价(GRADE)对报告质量、偏倚风险、方法学和证据进行独立评估。

结果

共有八篇论文符合纳入标准。具体而言,AMSTAR 2将五篇系统评价评为极低质量,三篇评为低质量。ROBIS将八篇系统评价中的四篇评为“低风险”。关于PRISMA,八篇系统评价中有四篇得分超过50%。基于GRADE工具,六篇系统评价中有两篇将母亲抑郁症状评为“中等”;五篇系统评价中有一篇将父亲抑郁症状评为“中等”;六篇系统评价中有一篇将家庭功能评估为“中等”,其他证据被评为“非常低”或“低”。在八篇系统评价中,六篇(75%)报告母亲抑郁症状显著减轻,两篇(25%)未报告。

结论

以家庭为中心的干预措施可能改善母亲的抑郁症状和家庭功能,但对父亲的抑郁症状无效。然而,纳入的以家庭为中心的围产期抑郁症干预措施的系统评价在方法学、证据、报告和偏倚风险方面的质量并不令人满意。上述缺点可能对系统评价产生负面影响,进而导致结果不一致。因此,需要偏倚风险低、高质量证据、标准报告和严格方法学的系统评价,以提供以家庭为中心的围产期抑郁症干预措施疗效的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f412/10267375/7012fc3408eb/fpsyt-14-1094360-g0001.jpg

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