认知行为疗法对心力衰竭患者抑郁的影响:一项系统回顾和荟萃分析。

PubMed ID
发表日期 2017年11月

原始出处 心力衰竭回顾
Heart failure reviews
作者 Jeyanantham  Kishaan  Kotecha  Dipak  Thanki  Devsaagar  Dekker  Rebecca  Lane  Deirdre A 

文献标题 认知行为疗法对心力衰竭患者抑郁的影响:一项系统回顾和荟萃分析。
Effects of cognitive behavioural therapy for depression in heart failure patients: a systematic review and meta-analysis.

文献摘要

本系统回顾和荟萃分析旨在评估认知行为疗法(CBT)对心力衰竭患者抑郁、生活质量、住院率和死亡率的影响。搜索策略是为Ovid MEDLINE开发的,并进行了相应修改,以搜索以下书目数据库:PubMed、EMBASE、PsycINFO、CENTRAL和CINAHL。从开始到2016年3月6日,我们对数据库进行了搜索,以了解在患有抑郁或抑郁症状的心力衰竭患者中使用CBT的随机对照试验(RCT)或观察研究。共有6项研究:5项随机对照试验和1项观察性研究,包括320名主要为NYHA II-III级的参与者,他们大多为男性,平均年龄在55至66岁之间。与常规治疗相比,CBT与抑郁评分在CBT治疗后的最初(标准化平均差-0.34,95%CI-0.60-0.08,p=0.01)和随访3个月(标准化平均差-0.32,95%CI-0.59-0.04,p=0.03)的抑郁评分均有较大改善。CBT治疗组在开始CBT治疗后生活质量评分明显改善,但在3个月时没有差异。无论治疗组,入院人数和死亡率均相似。对于最初接受CBT治疗的心力衰竭患者和3个月后的抑郁症患者,CBT可能比常规护理更有效地改善抑郁评分和生活质量。需要更大和更强大的随机对照试验来评估心功能衰竭患者CBT的长期临床效果。


This systematic review and meta-analysis aimed to evaluate the effects of cognitive behavioural therapy (CBT) on depression, quality of life, hospitalisations and mortality in heart failure patients. The search strategy was developed for Ovid MEDLINE and modified accordingly to search the following bibliographic databases: PubMed, EMBASE, PsycINFO, CENTRAL and CINAHL. Databases were searched from inception to 6 March 2016 for randomised controlled trials (RCTs) or observational studies that used CBT in heart failure patients with depression or depressive symptoms. Six studies were identified: 5 RCTs and 1 observational study, comprising 320 participants with predominantly NYHA classes II-III, who were mostly male, with mean age ranging from 55 to 66 years. Compared to usual care, CBT was associated with a greater improvement in depression scores both initially after CBT sessions (standardised mean difference -0.34, 95% CI -0.60 to -0.08, p = 0.01) and at 3 months follow-up (standardised mean difference -0.32, 95% CI -0.59 to -0.04, p = 0.03). Greater improvement in quality of life scores was evident for the CBT group initially after CBT sessions, but with no difference at 3 months. Hospital admissions and mortality were similar, regardless of treatment group. CBT may be more effective than usual care at improving depression scores and quality of life for heart failure patients initially following CBT and for depression at 3 months. Larger and more robust RCTs are needed to evaluate the long-term clinical effects of CBT in heart failure patients.


获取全文 10.1007/s10741-017-9640-5