School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
Black Dog Institute, Randwick, New South Wales, Australia.
BMJ Open. 2023 Jul 12;13(7):e064758. doi: 10.1136/bmjopen-2022-064758.
Mind-body exercise (MBE) interventions, such as yoga, are increasingly recognised as an adjunct treatment for trauma-related mental disorders but less is known about their efficacy as a preventative intervention. We aimed to systematically review if, and what type of, MBE interventions are effective at preventing the development of post-traumatic stress disorder (PTSD) or acute stress disorder (ASD) in trauma-exposed populations.
Systematic review and meta-analysis.
A systematic search of MEDLINE, PsycINFO, EMBASE and CENTRAL databases was conducted to identify controlled trials of MBE interventions aimed at preventing the development of PTSD or ASD in high-risk populations. Risk of bias was assessed using the revised Cochrane risk-of-bias and ROBINS-I tools. Pooled effect sizes using Hedges' and 95% CIs were calculated using random effects modelling for the main meta-analysis and planned subgroup and sensitivity analyses.
Six studies (N analysed=399) were included in the final meta-analysis. Overall, there was a small effect for MBE interventions in preventing the development of PTSD (0.25, 95% CI -0.56 to 0.06) among those with previous or ongoing exposure to trauma. Although a prespecified subgroup analyses comparing the different types of MBE intervention were conducted, meaningful conclusions could not be drawn due to the small number of studies. None of the included studies assessed ASD symptoms.
Limited evidence was found for MBE interventions in reducing PTSD symptomology in the short term. Findings must be interpreted with caution due to the small number of studies and possible publication bias.
CRD42020180375.
身心锻炼（MBE）干预措施，如瑜伽，越来越被认为是创伤相关精神障碍的辅助治疗方法，但对于其作为预防干预措施的效果知之甚少。我们旨在系统地评估 MBE 干预措施是否以及何种类型能够有效预防创伤后应激障碍（PTSD）或急性应激障碍（ASD）在创伤暴露人群中的发生。
系统回顾和荟萃分析。
系统检索 MEDLINE、PsycINFO、EMBASE 和 CENTRAL 数据库，以确定旨在预防高危人群 PTSD 或 ASD 发展的 MBE 干预措施的对照试验。使用修订后的 Cochrane 偏倚风险和 ROBINS-I 工具评估偏倚风险。使用随机效应模型计算主要荟萃分析和计划的亚组和敏感性分析的 Hedges' 合并效应大小和 95%CI。
最终荟萃分析纳入了 6 项研究（N 分析=399）。总体而言，对于那些有既往或持续创伤暴露的人，MBE 干预措施在预防 PTSD 发展方面有较小的效果（0.25，95%CI-0.56 至 0.06）。尽管进行了比较不同类型 MBE 干预措施的预设亚组分析，但由于研究数量较少，无法得出有意义的结论。没有纳入的研究评估 ASD 症状。
有限的证据表明 MBE 干预措施可在短期内减轻 PTSD 症状。由于研究数量较少且可能存在发表偏倚，因此必须谨慎解释这些发现。
PROSPERO 注册号：CRD42020180375。
