Department of Health Management, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, China.
BMC Nephrol. 2024 Jan 10;25(1):17. doi: 10.1186/s12882-023-03447-0.
People with chronic kidney disease (CKD) treated with dialysis are frequently affected by depression. Psychotherapy has been reported to decrease depressive symptoms in various chronic diseases and is a potential treatment option for depression. We aimed to perform a systematic review and meta-analysis to evaluate the effect of psychotherapy on depression in adults with CKD.
We searched MEDLINE, Embase, Web of Science, and Cochrane for published studies up to October 31, 2023. Two investigators independently reviewed the included studies and extracted relevant data. Randomized controlled trials (RCTs) assessing the impact of interventions that provide psychological, emotional, or social support without the use of pharmacological substances on depressive symptoms in people with CKD were included and summarized. Scores on different tools for depressive assessment and quality of life were pooled.
A total of 19 RCTs published between 2004 and 2023 were included and analyzed. The weighted mean difference (WMD) for all included studies with regard to depression was - 2.32 (95%CI=-3.83, -0.80, P = 0.003). The WMD for Beck Depression Inventory (BDI) score of depression was - 3.27 (95%CI=-7.81, 1.27, P = 0.158) with significant heterogeneity (I = 95.1%). Significant WMD was detected for the Hospital Anxiety and Depression Scale (HADS) tool: WMD=-1.90, 95%CI=-2.91, -0.90, P < 0.001. The WMD for all included studies regarding quality of life was 1.21 (95%CI=-0.51, 2.93, P = 0.168). The WMD for Kidney Disease Quality of Life Short Form (KDQOL-SF) score was 4.55 (95%CI = 0.50, 8.60, P = 0.028). The WMD for SF-36 score was 0.02 (95%CI=-10.33, 10.36, P = 0.998). Significant difference on outcomes of S-PRT scale was observed (WMD = 2.42, 95%CI = 1.07, 3.76, P < 0.001).
Psychosocial interventions probably reduce the depression level among CKD patients. Preliminary evidence suggests that psychosocial interventions might be beneficial for the quality of life in CKD patients. Our results provide medical facilities with an evidence-based basis for establishing psychosocial interventions in kidney care settings.
接受透析治疗的慢性肾脏病 (CKD) 患者经常受到抑郁症的影响。心理治疗已被报道可降低各种慢性疾病中的抑郁症状，是治疗抑郁症的潜在选择。我们旨在进行系统评价和荟萃分析，以评估心理治疗对 CKD 成人抑郁的影响。
我们检索了 MEDLINE、Embase、Web of Science 和 Cochrane 截至 2023 年 10 月 31 日发表的研究。两名调查员独立审查纳入的研究并提取相关数据。纳入评估提供心理、情感或社会支持而不使用药物物质对 CKD 患者抑郁症状影响的干预措施的随机对照试验 (RCT)，并进行总结。不同抑郁评估工具和生活质量的评分进行了汇总。
共纳入 2004 年至 2023 年发表的 19 项 RCT 进行分析。所有纳入研究的加权均数差 (WMD) 为-2.32（95%CI=-3.83，-0.80，P=0.003）。贝克抑郁量表 (BDI) 评分的 WMD 为-3.27（95%CI=-7.81，1.27，P=0.158），存在显著异质性（I=95.1%）。医院焦虑和抑郁量表 (HADS) 工具的显著 WMD 检测到：WMD=-1.90，95%CI=-2.91，-0.90，P<0.001。所有纳入研究的 WMD 与生活质量相关为 1.21（95%CI=-0.51，2.93，P=0.168）。KDQOL-SF 评分的 WMD 为 4.55（95%CI=0.50，8.60，P=0.028）。SF-36 评分的 WMD 为 0.02（95%CI=-10.33，10.36，P=0.998）。S-PRT 量表的结局观察到显著差异（WMD=2.42，95%CI=1.07，3.76，P<0.001）。
心理社会干预可能会降低 CKD 患者的抑郁水平。初步证据表明，心理社会干预可能有益于 CKD 患者的生活质量。我们的研究结果为医疗机构在肾脏护理环境中建立心理社会干预提供了循证依据。
