新冠康复期及长期新冠患者的心理治疗——关于现有及新出现干预措施的可行性、可接受性、安全性和有效性的系统评价
Psychotherapy in patients with long/post-COVID - A systematic review on the feasibility, acceptability, safety, and efficacy of available and emerging interventions.
作者信息
Schurr Marisa, Graf Johanna, Junne Florian, Giel Katrin Elisabeth
机构信息
Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Osianderstr.5, 72076 Tübingen, Germany.
Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Osianderstr.5, 72076 Tübingen, Germany; Clinic for Psychosomatic Medicine and Psychotherapy, Klinikum Stuttgart, Prießnitzweg 24, 70374 Stuttgart, Germany.
出版信息
J Psychosom Res. 2025 Mar;190:112048. doi: 10.1016/j.jpsychores.2025.112048. Epub 2025 Feb 8.
BACKGROUNDS
There is an urgent need for effective treatments for patients with long/post-COVID. Current recommendations for management favor a multimodal approach including psychotherapy and emphasize that interventions should also consider the mental health impact of living with long/post-COVID. This systematic review synthesizes psychotherapeutic interventions that currently target long/post-COVID complaints and summarizes data on the feasibility, acceptability, safety, and efficacy of psychotherapy for patients with long/post-COVID.
METHODS
This systematic review was conducted according to the PRISMA statement. Studies were retrieved from three databases (PubMed, PsycInfo, Web of Science) and independently assessed by two raters. Studies investigating patients of any age suffering from long/post-COVID were included if the intervention involved psychotherapeutic treatment and changes in long/post-COVID symptoms were reported. The review has been pre-registered on PROSPERO.
RESULTS
A total of 12 studies were included in the analysis. Of these, 10 were multimodal approaches with integrated psychotherapeutic interventions, and two were studies on stand-alone psychotherapy. The majority of studies were uncontrolled and demonstrate pre-post improvements in a range of long/post-COVID symptoms. Only one RCT could be identified, which supports the benefit of CBT for COVID-related fatigue. It was not possible to draw general conclusions regarding the efficacy of psychotherapy for long/post-COVID. However, data on feasibility, acceptability, and safety support the potential of psychotherapy as a treatment approach for long/post-COVID.
CONCLUSION
Future studies investigating the potential of psychotherapy approach for long/post-COVID which go beyond the pilot stage are needed to systematically assess feasibility, acceptability, safety, and efficacy in large-scale confirmatory trials.
背景
对于长期新冠/新冠康复患者,迫切需要有效的治疗方法。目前的管理建议倾向于采用包括心理治疗在内的多模式方法,并强调干预措施还应考虑长期新冠/新冠康复患者生活中的心理健康影响。本系统评价综合了目前针对长期新冠/新冠康复相关症状的心理治疗干预措施,并总结了心理治疗对长期新冠/新冠康复患者的可行性、可接受性、安全性和有效性的数据。
方法
本系统评价按照PRISMA声明进行。从三个数据库(PubMed、PsycInfo、Web of Science)检索研究,并由两名评估者独立评估。如果干预措施涉及心理治疗且报告了长期新冠/新冠康复症状的变化,则纳入调查任何年龄长期新冠/新冠康复患者的研究。该评价已在PROSPERO上预先注册。
结果
分析共纳入12项研究。其中,10项为采用综合心理治疗干预措施的多模式方法,2项为关于单独心理治疗的研究。大多数研究没有对照,显示出一系列长期新冠/新冠康复症状在治疗前后有所改善。仅识别出一项随机对照试验,该试验支持认知行为疗法对新冠相关疲劳的益处。无法就心理治疗对长期新冠/新冠康复的疗效得出一般性结论。然而,关于可行性、可接受性和安全性的数据支持心理治疗作为长期新冠/新冠康复治疗方法的潜力。
结论
未来需要开展超越试点阶段的研究,以调查心理治疗方法对长期新冠/新冠康复的潜力,从而在大规模验证性试验中系统评估其可行性、可接受性、安全性和有效性。