背景:许多研究表明,心理干预措施可有效缓解癌症患者的焦虑和抑郁情绪。然而,如何进行最佳的心理干预以减轻癌症患者的焦虑和抑郁情绪,目前尚不清楚.本研究旨在对癌症患者焦虑和抑郁的各种心理干预措施的比较效果进行比较和排名。
方法:数据库,即PubMed,Embase,科克伦图书馆,WebofScience,PsycINFO,CNKI,万方,从成立日期到2023年12月,对VIP和CBM进行了系统搜索,以进行针对癌症患者焦虑和抑郁的心理干预的随机对照试验。利用CochraneReviewManager5.4,我们根据Cochrane手册5.1.0方法学质量评估标准评估了当前研究中包含的研究中的偏倚风险。使用STATA15.0进行NMA。这项研究不涉及人类参与者,因此不需要伦理批准。
结果:纳入了31项随机对照试验,涉及3471名参与者。MT[SMD=1.35,95%CI(0.76,1.93)]和认知行为疗法(CBT)[SMD=0.97,95%CI(0.53,1.42)]在缓解焦虑方面优于常规护理。此外,人际心理治疗(IPT)[SMD=1.17,95%CI(0.06,2.28)],CBT[SMD=0.97,95%CI(0.63,1.30)],MT[SMD=0.93,95%CI(0.35,1.50)]在缓解抑郁症方面优于常规治疗。此外,CBT在缓解抑郁方面优于家庭治疗[SMD=0.73,95%CI(0.08,1.38)]。MT,CBT,IPT在缓解焦虑方面排名前三,而IPT,CBT,MT在缓解抑郁症方面排名前三位。
结论:MT和IPT将是减轻癌症患者焦虑和抑郁的更合适的选择,分别。这项研究还表明,CBT在缓解癌症患者的负面情绪方面具有显着作用。然而,结果需要通过高质量和大样本研究来验证.
BACKGROUND: Numerous studies have demonstrated that psychological interventions are effective in alleviating anxiety and depression in patients with cancer. However, the optimal psychological intervention to alleviate anxiety and depression in patients with cancer remains unknown. This study was carried out to compare and rank the comparative effectiveness of various psychological interventions on anxiety and depression in patients with cancer.
METHODS: Databases, namely PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CNKI, WanFang, VIP and CBM were systematically searched from their inception dates to December 2023 for randomized controlled trials of psychological interventions for anxiety and depression in patients with cancer. Utilizing the Cochrane Review Manager 5.4, we evaluated the risk of bias in the studies included in the current study based on the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria. The NMA was conducted using STATA 15.0. This study did not involve human participants and therefore did not require ethical approval.
RESULTS: Thirty-one randomized controlled trials involving 3471 participants were included. MT [SMD = 1.35, 95% CI (0.76, 1.93)] and cognitive behavioral therapy (CBT) [SMD = 0.97, 95% CI (0.53, 1.42)] were superior to usual care in alleviating anxiety. Besides, interpersonal psychotherapy (IPT) [SMD = 1.17, 95% CI (0.06, 2.28)], CBT [SMD = 0.97, 95 % CI (0.63, 1.30)], and MT [SMD = 0.93, 95% CI (0.35, 1.50)] were superior to usual care in alleviating depression. In addition, CBT was superior to family therapy in alleviating depression [SMD = 0.73, 95% CI (0.08, 1.38)]. The MT, CBT, and IPT ranked in the top three in alleviating anxiety, while IPT, CBT, and MT ranked in the top three in alleviating depression.
CONCLUSIONS: MT and IPT would be a more appropriate option in alleviating anxiety and depression in patients with cancer, respectively. This study also suggested that CBT had a significant effect in alleviating negative emotions in patients with cancer. However, the results need to be validated by high-quality and large-sample studies.