Yisma Engida, Walsh Sandra, Steen Mary, Gray Richard, Dennis Shaun, Gillam Marianne, Parange Nayana, Jones Martin
Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia.
IIMPACT in Health, University of South Australia, Adelaide, SA 5000, Australia.
Nurs Rep. 2024 Jan 3;14(1):78-88. doi: 10.3390/nursrep14010007.
Evidence shows that behavioral activation (BA), a simple form of psychological therapy, is as effective as the more complex psychological therapy-cognitive behavioral therapy (CBT)-in treating general depression. However, it remains unclear whether BA when compared with treatment-as-usual (TAU) has greater contributions in reducing postnatal depression. This systematic review compared the effect of BA versus TAU in reducing depression symptoms among postnatal women. Five databases (MEDLINE, Embase, Emcare, Cochrane Library, and PsycINFO) were searched. Risk of bias was assessed using the Cochrane Collaboration's 'risk-of-bias 2 tool'. A random-effects meta-analysis was conducted to examine the effect of BA on postnatal depression. Of 2844 initial studies, only two randomized control trials (RCTs) met the inclusion criteria. The overall quality of evidence of these two RCTs was low. When compared to TAU, meta-analysis showed that BA was associated with reduced depression symptoms in postnatal women (standard mean difference -0.56; 95% confidence interval -0.76 to -0.37). This review suggests that BA might be more effective than TAU for alleviating postnatal depression. However, due to concerns about evidence quality, these findings should be interpreted cautiously.
有证据表明，行为激活（BA）作为一种简单的心理治疗形式，在治疗一般性抑郁症方面与更复杂的心理治疗——认知行为疗法（CBT）效果相当。然而，与常规治疗（TAU）相比，行为激活在减轻产后抑郁症方面是否有更大作用仍不清楚。本系统评价比较了行为激活与常规治疗在减轻产后女性抑郁症状方面的效果。检索了五个数据库（MEDLINE、Embase、Emcare、Cochrane图书馆和PsycINFO）。使用Cochrane协作网的“偏倚风险2工具”评估偏倚风险。进行随机效应荟萃分析以检验行为激活对产后抑郁症的影响。在2844项初始研究中，只有两项随机对照试验（RCT）符合纳入标准。这两项随机对照试验的总体证据质量较低。与常规治疗相比，荟萃分析表明，行为激活与产后女性抑郁症状减轻有关（标准均差-0.56；95%置信区间-0.76至-0.37）。本评价表明，行为激活在减轻产后抑郁症方面可能比常规治疗更有效。然而，由于对证据质量的担忧，这些发现应谨慎解读。
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