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特应性皮炎患者焦虑和抑郁的干预措施:系统评价和荟萃分析。

Interventions for anxiety and depression in patients with atopic dermatitis: a systematic review and meta-analysis.

机构信息

Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, 10 Center Drive, Bethesda, MD, 20852, USA.

University of Illinois College of Medicine, Peoria, IL, USA.

出版信息

Sci Rep. 2024 Apr 17;14(1):8844. doi: 10.1038/s41598-024-59162-9.

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease that is associated with anxiety and depression. Few studies have addressed interventions for symptoms of anxiety and depression in this population. To determine the efficacy of interventions for anxiety and depression in patients with AD. PubMed, MEDLINE, EMBASE, and PsycINFO were searched from inception to November 2023. English-language studies published in peer-reviewed journals evaluating the effect of interventions on anxiety and/or depression using validated assessment tools on patients with AD were included. Titles, abstracts, and articles were screened by at least two independent reviewers. Of 1410 references that resulted in the initial search, 17 studies were included. Fourteen of these studies are randomized controlled trials, while the other 3 studies are prospective controlled trials with pre and post-test designs. Data were extracted using a standardized extraction form, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. To accommodate trials with multiple interventions (each compared to a control group), we conducted a mixed-effects meta-analysis with the trial as a random effect. Prespecified outcomes were changes in symptoms of anxiety and depression in patients with AD as evaluated using standardized assessment tools. Of the 17 studies included in this systematic review, 7 pharmacological intervention studies with 4723 participants examining 5 different medications were included in a meta-analysis. Of these studies, only 1 study evaluated medications prescribed to treat anxiety and/or depression; the rest evaluated medications prescribed to treat AD. Meta-analysis of all the pharmacological interventions resulted in significant improvement in anxiety, depression, and combined anxiety-depression scale scores (standardized mean difference [95% CI]: - 0.29 [- 0.49 to - 0.09], - 0.27 [- 0.45 to - 0.08], - 0.27 [- 0.45 to - 0.08]) respectively. The 10 non-pharmacological studies with 2058 participants showed general improvement in anxiety but not depression. A meta-analysis of the non-pharmacological interventions was not conducted due to variable approaches and limited data. Pharmacological interventions designed to improve AD were found to improve anxiety and depression in patients with moderate-severe disease. More comprehensive studies on non-pharmacological and pharmacological interventions that primarily target anxiety and depression are needed.

摘要

特应性皮炎(AD)是一种慢性炎症性皮肤病,与焦虑和抑郁有关。很少有研究针对该人群的焦虑和抑郁症状进行干预。为了确定 AD 患者焦虑和抑郁干预措施的疗效。从建库到 2023 年 11 月,检索了 PubMed、MEDLINE、EMBASE 和 PsycINFO。纳入了使用经过验证的评估工具评估干预措施对 AD 患者焦虑和/或抑郁影响的发表在同行评议期刊上的英语研究。至少由两名独立审查员筛选标题、摘要和文章。在最初的搜索中产生了 1410 篇参考文献,其中 17 项研究被纳入。其中 14 项为随机对照试验,另外 3 项为前瞻性对照试验,具有预测试和后测试设计。使用标准化提取表格提取数据,并遵循系统评价和荟萃分析的首选报告项目(PRISMA)指南。为了适应具有多种干预措施(每项与对照组进行比较)的试验,我们使用试验作为随机效应进行了混合效应荟萃分析。纳入的 17 项系统评价研究中,有 7 项药理学干预研究共纳入 4723 名参与者,研究了 5 种不同的药物,其中包括 1 项 meta 分析。在这些研究中,只有 1 项研究评估了用于治疗焦虑和/或抑郁的药物;其余研究评估了用于治疗 AD 的药物。所有药理学干预措施的荟萃分析结果表明,焦虑、抑郁和联合焦虑抑郁量表评分均显著改善(标准化均数差[95%CI]:-0.29[-0.49 至-0.09],-0.27[-0.45 至-0.08],-0.27[-0.45 至-0.08])。10 项纳入 2058 名参与者的非药理学研究表明,焦虑普遍改善,但抑郁无改善。由于方法多样且数据有限,因此未对非药理学干预措施进行荟萃分析。旨在改善 AD 的药理学干预措施被发现可改善中重度疾病患者的焦虑和抑郁。需要开展更多针对焦虑和抑郁的非药理学和药理学干预的综合研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e337/11024101/47ea456a61ac/41598_2024_59162_Fig1_HTML.jpg

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