Muyambi Kuda, Walsh Sandra, Gray Richard, Dennis Shaun, Brown Ellie, Grimshaw Marcus, Drummond Joanne, Jones Martin
University of South Australia Department of Rural Health, 111 Nicolson Avenue, Whyalla Norrie, 5600, SA, Australia.
University of South Australia IIMPACT in Health, Adelaide, 5000, SA, Australia.
Int J Nurs Stud Adv. 2023 May 15;5:100132. doi: 10.1016/j.ijnsa.2023.100132. eCollection 2023 Dec.
Negative symptoms, frequently experienced by people with schizophrenia, can impair functional outcomes and quality of life. Negative symptoms typically affect motivation, communication, and the ability to live independently and are difficult to treat. Several meta-analyses suggest that cognitive behavioural therapy results in a modest reduction in negative symptoms. It is unclear if similar effects can be achieved using behavioural activation. Behavioural activation is a derivative of cognitive behavioural therapy that helps to improve social and emotional functioning by encouraging patients to engage in activities that they value whilst modifying the avoidance responses. Behavioural activation can be a standalone treatment for depressive symptoms that is equally as efficacious as cognitive behavioural therapy.
This systematic review aimed to identify and summarise the evidence about the efficacy of behavioural activation in treating negative symptoms.
Systematic review.
SETTING/PARTICIPANTS: Two published studies conducted in South Korea and the United Kingdom recruited 55 patients.
We searched five databases and four trial registries for clinical treatment trials of behavioural activation involving adults diagnosed with negative symptoms of schizophrenia. Studies were screened according to the inclusion criteria and assessed for quality.
We identified 5023 published studies. After removing duplicates and conducting screening, two studies were included in this review. One study used a parallel non-randomised trial design whilst the other adopted a single group test-re-test design. Fifty-five participants were recruited from hospital and community settings. Both studies delivered 10 face-to-face sessions of behavioural activation; these were individual in one study and group sessions in the other. One study involved behavioural activation as the treatment whilst the other delivered behavioural activation with motivational interviewing. Neither study reported harms or adverse events.
Based on the included studies, there is low-quality evidence that behavioural activation may be helpful in the treatment of negative symptoms. Key limitations of the studies include small sample sizes and overall low study quality.
The protocol covering this review was registered with Open Science on 18 February 2022 (Registration DOI 10.17605/OSF.IO/57QSW; Weblink: https://osf.io/57qsw).
Behavioural activation holds promise in supporting patients experiencing negative symptoms of schizophrenia.
精神分裂症患者经常出现阴性症状，这会损害功能结局和生活质量。阴性症状通常会影响动机、沟通以及独立生活的能力，且难以治疗。多项荟萃分析表明，认知行为疗法可使阴性症状有一定程度的减轻。目前尚不清楚使用行为激活疗法是否能取得类似效果。行为激活疗法是认知行为疗法的一个分支，通过鼓励患者参与他们重视的活动，同时改变回避反应，来帮助改善社交和情感功能。行为激活疗法可以作为治疗抑郁症状的独立疗法，其疗效与认知行为疗法相当。
本系统评价旨在识别和总结行为激活疗法治疗阴性症状疗效的证据。
系统评价。
设置/参与者：在韩国和英国进行的两项已发表研究招募了55名患者。
我们在五个数据库和四个试验注册库中检索了涉及诊断为精神分裂症阴性症状的成年人的行为激活临床治疗试验。根据纳入标准对研究进行筛选并评估质量。
我们识别出5023项已发表研究。在去除重复项并进行筛选后，两项研究被纳入本评价。一项研究采用平行非随机试验设计，另一项采用单组前后测设计。55名参与者从医院和社区环境中招募。两项研究均进行了10次行为激活面对面治疗；一项研究为个体治疗，另一项为团体治疗。一项研究将行为激活作为治疗方法，另一项研究将行为激活与动机性访谈相结合。两项研究均未报告危害或不良事件。
基于纳入的研究，有低质量证据表明行为激活疗法可能有助于治疗阴性症状。研究的主要局限性包括样本量小和总体研究质量低。
涵盖本评价的方案于2022年2月18日在开放科学平台注册（注册DOI 10.17605/OSF.IO/57QSW；网络链接：https://osf.io/57qsw）。
行为激活疗法有望帮助患有精神分裂症阴性症状的患者。
