mental health treatment

心理健康治疗
  • 文章类型: Journal Article
    目的:探讨抗阻训练对减轻青少年焦虑、抑郁症状的治疗效果。
    方法:我们搜索了MEDLINE,心理信息,和PubMed从1980年1月至2023年9月以英文发表的关于随机对照试验(RCT)的文章,其中包括至少4周的阻力训练,受试者年龄在26岁或以下,焦虑和抑郁症状临床升高。与对照组相比,使用随机效应荟萃分析来计算干预前后阻力训练的汇总效应大小。使用Cochrane偏见风险2(RoB2)和建议分级评估证据质量,评估,发展,和评估(等级)标准。
    结果:十个RCT,涉及376名参与者(209名女性和127名男性),临床,基于社区的环境符合纳入分析的条件.阻力训练与抑郁(Hedge'sg=-1.06,95%CI-1.61至-0.51,p<.001)和焦虑(Hedge'sg=-1.02,95%CI-1.50至-0.54,p<.001)症状的显著减少相关。在抑郁症状(I2=79%)和焦虑症状(I2=66%)的分析中观察到了很大的异质性。六项试验的偏倚风险很低,四项试验显示了一些担忧。GRADE分析显示抑郁症状的确定性很高,焦虑症状的确定性为中等水平。
    结论:抗阻训练是减轻青少年抑郁和焦虑症状的有效干预措施,在一系列设置中交付。未来的试验探索阻力训练干预的效果与长期随访是必要的,以了解结果。
    OBJECTIVE: To determine the treatment effect of resistance training in reducing symptoms of anxiety and depression in young people.
    METHODS: We searched MEDLINE, PsychINFO, and PubMed for articles published in English from January 1980 to September 2023 for randomized controlled trials (RCT) that included at least 4 weeks of resistance training, with participants aged 26 years or younger with clinically elevated anxiety and depression symptoms. A random-effects meta-analysis was used to calculate a pooled effect size of resistance training pre-and post-intervention compared to control groups. The quality of evidence was assessed using the Cochrane risk-of-bias 2 (RoB 2) and Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria.
    RESULTS: Ten RCTs involving 376 participants (209 females and 127 males) across educational, clinical, and community based setting were eligible for inclusion in the analysis. Resistance training was associated with a significant reduction in depressive (Hedge\'s g = -1.06, 95% CI -1.61 to -0.51, p < .001) and anxiety (Hedge\'s g = -1.02, 95% CI -1.50 to -0.54, p < .001) symptoms. Substantial heterogeneity was observed in the analysis of depression symptoms (I2 = 79%) and anxiety symptoms (I2 = 66%). Six trials had a low risk of bias, four trials showed some concerns. The GRADE analysis demonstrated a high level of certainty for depressive symptoms and a moderate level for anxiety symptoms.
    CONCLUSIONS: Resistance training is an effective intervention in reducing depression and anxiety symptoms in young people, delivered across a range of settings. Future trials exploring the effect resistance training interventions with long-term follow up are warranted to understand the outcomes.
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  • 文章类型: Journal Article
    虚拟现实(VR)已有效地用于治疗许多心理健康障碍。然而,文献中存在显著差距。研究人员在开发新的VR治疗方法时没有可使用的治疗框架。在一系列诊断中推荐的一种治疗方法,这可能适用于VR治疗,认知行为疗法(CBT)。本系统综述的目的是研究利用VR治疗心理健康障碍的CBT治疗方法。
    为了调查如何在VR中使用CBT来治疗心理健康障碍,并报告治疗特征(会议次数,持续时间,和频率)与有效和无效的试验有关。
    如果患者有心理健康诊断,并且他们的治疗包括沉浸式VR技术和CBT原则,则包括研究。提取与治疗特征和结果相关的数据,并使用叙事综合进行分析。
    分析了93项研究。基于暴露的VR治疗主要用于治疗焦虑相关疾病。治疗通常包括八个疗程,每周一次,大约一个小时。VR治疗通常等于或比传统的面对面方法更有效。没有具体的治疗特征与这种有效性相关。
    数字,本综述中确定的VR治疗会话的频率和持续时间,可作为研究人员和临床医生的治疗框架。这可能会在开发新的干预措施时节省研究人员的时间和金钱。
    UNASSIGNED: Virtual reality (VR) has been effectively used in the treatment of many mental health disorders.However, significant gaps exist in the literature. There is no treatment framework for researchers to use when developing new VR treatments. One recommended treatment across a range of diagnoses, which may be suitable for use in VR treatments, is Cognitive Behavioural Therapy (CBT). The aim of this systematic review is to investigateCBT treatment methods that utilize VR to treat mental health disorders.
    UNASSIGNED: To investigate how CBT has been used in VR to treat mental health disorders and to report onthe treatment characteristics (number of sessions, duration, and frequency) that are linked to effective and ineffective trials.
    UNASSIGNED: Studies were included if patients had a mental health diagnosis and their treatment included immersiveVR technology and CBT principles. Data were extracted in relation to treatment characteristics and outcomes,and analysed using narrative synthesis.
    UNASSIGNED: Ninety-three studies were analysed. Exposure-based VR treatments were mainly used to treat anxiety related disorders. Treatments generally consisted of eight sessions, once a week for approximately one hour. VR treatments were commonly equal to or more effective than traditional face-to-face methods. No specific treatment characteristics were linked to this effectiveness.
    UNASSIGNED: The number, frequency and duration of the VR treatment sessions identified in this review, could be used as a treatment framework by researchers and clinicians. This could potentially save researchers time and money when developing new interventions.
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  • 文章类型: Journal Article
    BACKGROUND: According to the United Nations Convention on the Rights of the Child, adolescents\' involvement in their healthcare is a fundamental right, and self-engagement in mental health treatment is vital for realizing their potential within person-centered care (PCC). Research exists that highlights barriers to involving adolescents in their care decisions. However, research on adolescents\' own voices about self-engagement in mental health treatment has been scarce. This scoping review aimed to examine and summarize current knowledge on adolescents\' voices regarding self-engagement in mental health treatment.
    METHODS: The review followed the scoping methodology of Arksey and O\'Malley from 2005, updated by Levac and colleagues in 2010, involving five stages: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collating, summarizing and reporting the results.
    RESULTS: Nineteen studies were included. The following themes on adolescents` voices regarding self-engagement in mental health treatment were identified: (1) the therapeutic alliance, (2) the need for active engagement in treatment, (3) different experiences due to time of data collection, (4) treatment context and healthcare system, and (5) adolescent-caregiver interaction.
    CONCLUSIONS: Adolescents\' understanding of self-engagement was multilevel and comprehensive, including individual, contextual and relational factors. A strong therapeutic alliance with healthcare providers, and a need to be actively engaged in treatment were highlighted. To succeed in strengthening PCC in mental healthcare for adolescents, health professionals must take this complex understanding into consideration, as treatment without adolescents` self-engagement may worsen their clinical outcomes. Future research should explore specific PCC interventions and incorporate diverse methodologies in various clinical contexts. Additionally, insights from healthcare providers and caregivers on self-engagement in mental health treatment will complement these findings.
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    文章类型: Journal Article
    在一次自杀未遂之后,善后护理的组成部分可以包括减少自杀行为的努力(即,自杀,尝试,或意念)试图自杀并促进患者及其家人心理社会适应的人。本系统评价和荟萃分析的主要结果的目的是综合现有的证据,对自杀未遂者及其家庭成员进行干预。作者发现,善后干预显示,干预参与者的进一步自杀尝试在统计学上显着减少。研究还报告了自杀死亡人数的减少,抑郁症,和绝望,但结果是基于有限的证据质量。干预措施的吸收和治疗保留率因善后干预而差异很大。作者无法探索干预目标的效果(例如,尝试自杀的参与者与家庭成员或两者)或人群,因为样本的同质性以及缺乏测量家庭成员反应的研究。已确定的研究没有有意义地解决干预措施对家庭成员的影响,因为这些很少包括在现有的研究中。
    Following a suicide attempt, components of aftercare can include efforts to reduce suicidal behavior (i.e., suicide, attempt, or ideation) of a person who has attempted suicide and facilitate the psychosocial adjustment of the patient and their family members. The purpose of this systematic review and meta-analysis of key outcomes was to synthesize the existing evidence on interventions for people who have attempted suicide and their family members. The authors found that aftercare interventions show a statistically significant reduction in further suicide attempts for intervention participants. Studies also reported a reduction in suicide deaths, depression, and hopelessness, but the results are based on limited quality of evidence. The uptake of interventions and treatment retention varied widely by aftercare intervention. The authors could not explore the effects of the intervention target (e.g., participants who attempted suicide versus family members or both) or populations because of the homogeneity of the sample and the lack of studies measuring family member responses. The identified studies did not meaningfully address the effects of interventions on family members because these were rarely included in existing research studies.
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  • 文章类型: Meta-Analysis
    加强社交网络是心理健康治疗的重要目标。本研究旨在确定社会网络干预对精神病患者的有效性。进行了系统评价和荟萃分析,比较了这些干预措施与对照组对精神病患者的社会和心理健康相关结局的影响。PubMed,EMBASE.com,PsycInfo,Scopus,和IBSS进行了搜索研究,直到2022年12月21日。使用三级随机效应模型来获得Cohen对社交网络和次要心理健康结果的综合结果的平均估计。用潜在的调节者检查异质性。包括33项研究。社会网络干预对积极的社会网络(d=0.115,p=0.022)和支持(d=0.159;p=0.007)检测到小到中等的影响,一般功能(d=0.127,p=0.046),心理健康治疗依从性(d=0.332,p=0.003),物质使用天数(d=0.097,p=0.004),和禁欲(d=0.254,p=0.004)。女性较多的样本对精神功能的估计较高。证据质量为中低。这些证据表明,社交网络干预可以改善积极的社交网络,一般功能,心理健康治疗依从性,以及接受常规护理的精神病患者的药物使用情况。PROSPEROID:CRD42019131959.
    Strengthening social networks is an important goal in mental health treatment. This study aimed to determine the effectiveness of social network interventions for psychiatric patients. A systematic review and meta-analysis was conducted comparing these interventions with control groups on social and mental health-related outcomes in psychiatric patients. PubMed, EMBASE.com, PsycInfo, Scopus, and IBSS were searched for studies until December 21, 2022. Three-level random effects models were used to obtain Cohen\'s d mean estimates on composite outcomes of social network and secondary mental health outcomes. Heterogeneity was examined with potential moderators. Thirty-three studies were included. Small-to-moderate effects of social network interventions were detected on positive social network (d = 0.115, p = 0.022) and support (d = 0.159; p = 0.007), general functioning (d = 0.127, p = 0.046), mental health treatment adherence (d = 0.332, p = 0.003), days substance use (d = 0.097, p = 0.004), and abstinence (d = 0.254, p = 0.004). Estimates of psychiatric functioning were higher in samples with more females. The quality of evidence was moderate-to-low. This evidence suggests that social network interventions can improve positive social networks, general functioning, mental health treatment adherence, and substance use in psychiatric patients receiving usual care. PROSPERO ID: CRD42019131959.
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  • 文章类型: Journal Article
    本文包括对用于改善被关押在美国监狱和监狱中的男性和女性心理健康的治疗干预措施的系统回顾。使用相关的关键字,我们搜索了以下数据库:Socindex,CINAHL完成,MedlineComplete,心理信息,心理学与行为科学合集,以及2010年至2021年期间发表的研究报告的刑事司法摘要和全文。最初的搜索产生了9,622篇文章。筛选后,28篇文章符合纳入标准,并进行了综述。审查表明,使用各种干预措施来解决心理健康结果,包括,但不限于,创伤后应激障碍,抑郁症,和焦虑。一些研究没有关注特定的心理健康结果,而是在诸如痛苦之类的行为结果上,影响,心情,在医院度过的时光,自我伤害行为的数量,能力恢复,以及参与者的福祉。该综述包括对未来研究和实践的启示。
    The article includes a systematic review of therapeutic interventions being used to improve mental health of males and females incarcerated in U.S. jails and prisons. Using pertinent keywords, we searched the following databases: SocINDEX, CINAHL Complete, Medline Complete, PsychINFO, Psychology and Behavioral Sciences Collection, and Criminal Justice Abstracts with Full Text for studies published between 2010 and 2021. The initial search yielded 9,622 articles. After screening, 28 articles met the inclusion criteria and were reviewed. Review indicated use of a diverse range of interventions to address mental health outcomes including, but not limited to, PTSD, depression, and anxiety. A few studies did not focus on specific mental health outcomes, but rather on behavioral outcomes such as distress, affect, mood, time spent in the hospital, number of acts of self-injury, competency restoration, and wellbeing of the participants. The review includes implications for future research and practice.
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    文章类型: Journal Article
    尽管当患者在工作或保险公司之间移动时,医疗保健系统之间的过渡很常见,当患有精神疾病的患者离开综合系统时,它们尤其难以导航,例如军事卫生系统(MHS)。作者综合了干预措施研究的证据,这些干预措施促进了精神卫生保健系统之间的过渡,例如从MHS过渡到退伍军人健康管理局(VHA)。作者搜索了多个研究数据库,现有评论的参考挖掘书目,并与专家协商,以确定对过渡支持干预措施的现有评估。关键线人帮助确定了在医疗保健系统之间过渡的相关关注人群。评估不同方法的17项研究符合纳入标准。研究报告了不同的结果,很少能在汇总分析中结合起来。分析表明,护理过渡干预可以增加门诊精神卫生服务的使用,但整体证据是有限的.
    Although transitions between health care systems are common when patients move between jobs or insurers, they are especially difficult to navigate when patients with mental health conditions leave an integrated system, such as the Military Health System (MHS). The authors synthesize evidence from studies of interventions that facilitate transitions between mental health care systems, such as the transition from the MHS to the Veterans Health Administration (VHA). The authors searched multiple research databases, reference-mined bibliographies of existing reviews, and consulted with experts to identify existing evaluations of transition support interventions. Key informants helped identify pertinent populations of interest who are transitioning between health care systems. Seventeen studies evaluating different approaches met inclusion criteria. Studies reported on different outcomes, and few could be combined in aggregated analyses. Analyses showed that care transition interventions can increase outpatient mental health service use, but the overall body of evidence is limited.
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    文章类型: Journal Article
    军事人员,警察,消防员,其他急救人员必须每天为威胁生命的危机做好准备和应对。这种生活方式给员工带来压力,尤其是可能与支持系统和其他资源隔离的军事人员。作者对旨在预防,identify,管理军队中的急性职业压力,执法,第一响应者。证据包括38项对照试验,35个队列比较,和42个没有对照组的案例研究,136种出版物。干预措施包括韧性训练,用生物反馈进行应激接种,正念,心理急救,一线精神卫生中心,为期两到七天的修复计划,汇报(包括关键事件压力汇报),第三位置减压,部署后心理健康筛查,重返社会方案,和以家庭为中心的计划。研究局限性(偏倚风险),直接性,一致性,精度,在评估每个结局领域的证据质量时,考虑了发表偏倚.总的来说,干预措施对重返工作岗位有积极影响,旷工,和痛苦。然而,对PTSD等心理障碍的症状没有显着影响,抑郁症,和焦虑。由于研究的局限性,结果不一致,间接性,以及可能的出版偏见,没有足够的证据来得出关于大多数特定干预类型的效果的结论,组件,设置,或特定人群。
    Military personnel, police officers, firefighters, and other first responders must prepare for and respond to life-threatening crises on a daily basis. This lifestyle places stress on personnel, and particularly so on military personnel who may be isolated from support systems and other resources. The authors conducted a systematic review of studies of interventions designed to prevent, identify, and manage acute occupational stress among military, law enforcement, and first responders. The body of evidence consisted of 38 controlled trials, 35 cohort comparisons, and 42 case studies with no comparison group, reported in 136 publications. Interventions consisted of resilience training, stress inoculation with biofeedback, mindfulness, psychological first aid, front-line mental health centers, two- to seven-day restoration programs, debriefing (including critical incident stress debriefing), third-location decompression, postdeployment mental health screening, reintegration programs, and family-centered programs. Study limitations (risk of bias), directness, consistency, precision, and publication bias were considered in rating the quality of evidence for each outcome area. Overall, interventions had positive effects on return to duty, absenteeism, and distress. However, there was no significant impact on symptoms of psychological disorders such as PTSD, depression, and anxiety. Because of study limitations, inconsistency of results, indirectness, and possible publication bias, there was insufficient evidence to form conclusions about the effects of most specific intervention types, components, settings, or specific populations.
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  • 文章类型: Journal Article
    患有自闭症谱系障碍(ASD)的青年具有很高的共同发生的心理健康需求,需要进行心理健康干预。鉴于青年ASD患者的独特临床特征,在适应和测试针对该人群的心理健康干预措施方面,已经做出了重大努力。然而,对干预适应的性质和类型的表征是有限的,特别是针对ASD青年的各种干预措施进行了测试,重点是实施因素。此外,了解如何在社区服务中实施这些干预措施是有限的。本系统评价的目的是描述(1)对ASD青年同时发生的精神健康状况进行测试的干预措施类型;(2)对ASD青年使用的心理健康干预措施的适应;(3)实施策略,结果,以及心理健康干预措施的决定因素,以告知他们将其翻译为社区服务环境。回顾了83篇针对ASD青年心理健康症状的干预措施的文章,其中包括分析中的实施因素。Stirman等人。(2013年;2019年)框架适应,鲍威尔等人。(2012;2015)实施战略,和Proctor等人。(2011)实施成果分类法被应用于描述适应与ASD青年使用的性质和类型以及实施战略的类型,结果,和使用的行列式,当可用时,分别。在检查的干预措施中,大多数(64.1%)最初是针对青少年心理健康问题设计的,然后进行调整以用于ASD。最常见的改编包括对干预内容的改编,特别是在保持核心功能的同时,通过定制或改进干预方面来添加元素。一半的文章描述了在干预测试期间使用的至少一种实施策略。保真度和可接受性是最经常检查的实施结果,对适当性和可行性进行了一些检查。19%的文章描述了这些实施结果的实施决定因素(即障碍/促进因素)。ASD的常见适应为未来的干预发展和培训社区治疗师提供了方向。进一步检查,规格,需要在持续的适应和干预措施中报告实施战略和成果,以满足青年ASD共同出现的心理健康需求,以促进其转化为社区环境。讨论了未来研究的领域以及临床意义。
    Youth with autism spectrum disorder (ASD) have high rates of co-occurring mental health needs that necessitate mental health interventions. Given the unique clinical characteristics of youth with ASD, there have been significant efforts to adapt and test mental health interventions for this population. Yet, characterization of the nature and types of interventions adaptations is limited, especially across the wide range of interventions tested for youth with ASD with a focus on implementation factors. Additionally, understanding how these interventions may be implemented in community services is limited. The aims of this systematic review are to characterize the (1) types of interventions tested for co-occurring mental health conditions for youth with ASD; (2) adaptations to mental health interventions for use with youth with ASD; and (3) implementation strategies, outcomes, and determinants of mental health interventions to inform their translation to community service settings. Eighty-three articles testing interventions targeting mental health symptoms in youth with ASD that included implementation factors in analyses were reviewed. The Stirman et al. (2013; 2019) FRAME adaptation, Powell et al. (2012;2015) implementation strategies, and Proctor et al. (2011) implementation outcomes taxonomies were applied to characterize the nature and types of adaptations for use with youth with ASD and types of implementation strategies, outcomes, and determinants used, when available, respectively. Of the interventions examined, the majority (64.1%) were originally designed to target youth mental health concerns and were then adapted to be used with ASD. The most common adaptations included those to the intervention content, particularly adding elements with tailoring or refining aspects of the intervention while maintaining core functions. Half of the articles described at least one implementation strategy used during intervention testing. Fidelity and acceptability were the most frequently examined implementation outcomes, with some examination of appropriateness and feasibility. Nineteen percent of articles described implementation determinants (i.e. barriers/facilitators) of these implementation outcomes. The common adaptations for ASD provide direction for future intervention development and for training community therapists. Further examination, specification, and reporting of implementation strategies and outcomes within ongoing efforts to adapt and interventions to meet the co-occurring mental health needs of youth ASD are needed to facilitate their translation to community settings. Areas for future research as well as clinical implications are discussed.
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  • 文章类型: Journal Article
    在诊断和治疗的精神健康疾病导致慢性表现和后果。多种因素导致治疗差距,包括文化在发展或抑制求助行为(HSB)中的作用。在亚洲社区,对心理健康及其障碍的对话和认识被认为是可耻的。这篇综述对文献进行了分析,以确定亚洲人群中明显的心理健康治疗障碍,并讨论了文化如何影响这些障碍和寻求治疗的行为。特别是在2019年亚洲起源的冠状病毒病(COVID-19)全球大流行的背景下。这篇评论的目的是讨论亚裔美国人对精神卫生服务的利用不足,并了解导致亚裔社区精神病治疗抵抗的因素。
    Under diagnosis and treatment of mental health illnesses lead to chronic presentations and consequences. Multiple factors contribute to gaps in treatment, including the role culture plays in the development or suppression of help-seeking behaviors (HSBs). In the Asian community, conversation and recognition of mental health and its disorders are considered shameful. This review presents an analysis of literature to identify barriers to mental health treatment pronounced in Asian populations and discusses how culture influences these barriers and treatment-seeking behaviors, particularly in the context of the Asian-origin Coronavirus disease 2019 (COVID-19) global pandemic. It is the purpose of this review to discuss Asian American underutilization of mental health services and understand the factors the contribute to psychiatric care resistance in Asian communities.
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