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认知行为疗法与其他干预措施对感觉障碍患者心理健康的影响:一项系统评价与荟萃分析

Cognitive behavioural therapy versus other interventions on mental health in people with sensory impairments: A systematic review and meta-analysis.

作者信息

Trott M, Koblitz A, Pardhan S

机构信息

Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, UK; Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Services, Brisbane, Australia; Queensland Centre for Mental Health Research, Wacol, Brisbane, Australia.

Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, UK.

出版信息

J Psychosom Res. 2025 Feb;189:111998. doi: 10.1016/j.jpsychores.2024.111998. Epub 2024 Nov 30.

Abstract

BACKGROUND

Sensory impairments can negatively affect people's quality of life and daily functioning, including anxiety and depression symptoms. Cognitive behavioural therapy (CBT) could be an effective intervention to alleviate these, however its effectiveness compared to other interventions have not been examined. The aim of this review was to examine the effectiveness of CBT versus other interventions on anxiety and depression symptoms in people with hearing, visual, and other sensory impairments.

METHODS

This systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted using a pre-registered protocol (Prospero ID:CRD42023425953). Searches were conducted in across six databases from inception through October 2024. Random-effects meta-analyses were performed.

RESULTS

Of 18 included studies, interventions for tinnitus yielded a significant effect favouring intervention on anxiety (Hedge's g = 0.5;95 %CI0.3-0.9) and depression symptoms (Hedge's g = 0.4; 95 %CI 0.1-0.6). Interventions for people with hearing loss not related to tinnitus yielded a significant effect favouring intervention on anxiety symptoms (Hedge's g = 0.6;95 %CI 0.2-1.1), but not in depression symptoms (Hedge's g = 0.3;95 %CI -0.0;0.6). When sub-grouped, no significant differences between CBT and other interventions were found. Interventions for people with vision impairment yielded a non-significant difference in depression symptoms (Hedge's g = 0.4;95 %CI -0.0;0.7), with no studies found examining anxiety symptoms.

CONCLUSION

No significant differences were found when comparing CBT versus other interventions in hearing loss. The effectiveness of CBT for people with visual impairment was less clear due to a small number of studies. Future studies should consider other types of sensory impairments.

摘要

背景

感觉障碍会对人们的生活质量和日常功能产生负面影响,包括焦虑和抑郁症状。认知行为疗法(CBT)可能是缓解这些症状的有效干预措施,然而,与其他干预措施相比,其有效性尚未得到检验。本综述的目的是研究CBT与其他干预措施相比,对听力、视力和其他感觉障碍患者焦虑和抑郁症状的有效性。

方法

本系统评价和随机对照试验(RCT)的荟萃分析采用预先注册的方案(Prospero ID:CRD42023425953)进行。从数据库创建至2024年10月在六个数据库中进行检索。进行随机效应荟萃分析。

结果

在纳入的18项研究中,耳鸣干预措施对焦虑(Hedge's g = 0.5;95%CI 0.3 - 0.9)和抑郁症状(Hedge's g = 0.4;95%CI 0.1 - 0.6)产生了显著的干预效果。非耳鸣性听力损失患者的干预措施对焦虑症状(Hedge's g = 0.6;95%CI 0.2 - 1.1)产生了显著的干预效果,但对抑郁症状(Hedge's g = 0.3;95%CI -0.0;0.6)没有显著效果。分组时,未发现CBT与其他干预措施之间存在显著差异。视力障碍患者的干预措施在抑郁症状方面无显著差异(Hedge's g = 0.4;95%CI -0.0;0.7),未发现有研究考察焦虑症状。

结论

在听力损失方面,比较CBT与其他干预措施时未发现显著差异。由于研究数量较少,CBT对视力障碍患者的有效性尚不清楚。未来的研究应考虑其他类型的感觉障碍。

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