A systematic literature review was conducted in six databases and three-level meta-analytic models were used to statistically synthesize effect sizes and to examine moderators of the associations between PI and depressive, anxiety, and stress symptoms.
A total of 22 studies yielded 63 effect sizes on associations between PI and depressive, anxiety, or stress symptoms. The results of three separate meta-analyses revealed a large and significant association between PI and depressive (r = 0.580, 95 % CI [0.549; 0.775]), anxiety (r = 0.548, 95 % CI [0.468; 0.761]), and stress symptoms (r = 0.548, 95 % CI [0.506; 0.725]). The association between PI and depressive symptoms is stronger for males than for females, and the association between PI and stress symptoms varies by type of measure that primary studies use to assess PI and stress symptoms.
Temporal or causal conclusions are not allowed due to cross-sectional nature of the associations included in meta-analyses. Clinical samples with high levels of stress were underrepresented.
PI seems an important risk factor for symptoms of depression, anxiety, and stress, and should therefore be targeted in interventions addressing mental health problems during the COVID-19 pandemic and beyond.
方法:在六个数据库中进行了系统的文献综述,并使用三级荟萃分析模型来统计综合效应大小,并检查PI与抑郁之间的相关性的调节因素,焦虑,和压力症状。
结果:共有22项研究对PI和抑郁之间的关联产生了63种效应大小,焦虑,或压力症状。三个独立的荟萃分析的结果显示PI和抑郁之间有很大的显著关联(r=0.580,95%CI[0.549;0.775]),焦虑(r=0.548,95%CI[0.468;0.761]),和应激症状(r=0.548,95%CI[0.506;0.725])。男性的PI和抑郁症状之间的关联比女性更强,PI和应激症状之间的关联因主要研究用于评估PI和应激症状的测量类型而异。
结论:由于荟萃分析中包含的关联的横断面性质,不允许有时间或因果结论。具有高水平压力的临床样品代表性不足。
结论:PI似乎是抑郁症状的重要危险因素,焦虑,和压力,因此,应针对COVID-19大流行期间及以后的精神健康问题进行干预。