Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney 2109, Australia.
Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney 2109, Australia.
J Affect Disord. 2024 Jan 1;344:592-599. doi: 10.1016/j.jad.2023.10.093. Epub 2023 Oct 17.
This systematic review and meta-analysis examined the efficacy of low intensity psychological interventions for older adults (60+ years) with clinical anxiety and/or depressive disorders.
Systematic review and meta-analysis of randomised control trials of low-intensity psychological interventions for anxiety and/or depression with an active or passive control condition (e.g., waitlist, treatment-as-usual or active control) in any setting. Low intensity psychological interventions (e.g., cognitive behaviour therapy [CBT]) targeted anxiety and/or depression as primary outcomes, were primarily self-help, and included support from trained practitioners/facilitators with <6 h total contact time (typically <30 min p/contact).
Seven studies consisting of 304 older adults (65-78 years, M = 70, SD = 4) were identified and six included in the meta-analysis of depression outcomes and three for anxiety. A random effects meta-analysis of group differences in symptom change from pre-post treatment found evidence favouring low intensity psychological interventions over passive control groups for the treatment of depressive and anxiety symptoms, with moderate effect sizes for depression (Cohen's d = -0.62) and large effect sizes for anxiety (Cohen's d = -0.84) at post-treatment.
Results are limited by study design of included studies such that the efficacy of interventions compared to treatment-as-usual, non-CBT approaches, in adults >80 years and long-term effects are unknown.
There is some evidence supporting the clinical benefits of low intensity psychological interventions for depressive and anxiety symptoms in older adults compared to passive controls. More research is needed to examine efficacy compared to active control conditions, and among those over 80 years.
本系统评价和荟萃分析考察了低强度心理干预对有临床焦虑和/或抑郁障碍的老年患者（60 岁以上）的疗效。
对低强度心理干预治疗焦虑和/或抑郁的随机对照试验进行系统评价和荟萃分析，干预措施有积极或消极对照（如等待、常规治疗或积极对照），并在任何环境下进行。低强度心理干预（如认知行为疗法 [CBT]）将焦虑和/或抑郁作为主要结局，主要是自助式，且包括有经验的从业者/促进者的支持，总接触时间<6 小时（通常每次接触<30 分钟）。
确定了 7 项研究，共 304 名老年人（65-78 岁，M=70，SD=4），其中 6 项研究纳入抑郁结局的荟萃分析，3 项研究纳入焦虑的荟萃分析。从治疗前到治疗后的症状变化的组间差异进行随机效应荟萃分析发现，低强度心理干预优于消极对照组，可有效治疗抑郁和焦虑症状，治疗后抑郁的效应量中等（Cohen's d=-0.62），焦虑的效应量大（Cohen's d=-0.84）。
纳入研究的设计限制了结果，因此干预措施与常规治疗、非 CBT 方法相比在 80 岁以上成年人中的疗效以及长期疗效尚不清楚。
有一些证据支持低强度心理干预对老年患者的抑郁和焦虑症状的临床疗效优于消极对照组。需要更多的研究来比较与积极对照条件的疗效，以及在 80 岁以上人群中的疗效。
