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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Characteristics of psychological interventions that improve depression in people with coronary heart disease: A systematic review and meta-regression
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Characteristics of psychological interventions that improve depression in people with coronary heart disease: A systematic review and meta-regression

机译：改善冠心病患者抑郁症的心理干预措施的特征：系统评价和Meta回归

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OBJECTIVE: Despite previous intervention trials, it is unclear which psychological treatments are most effective for people with coronary heart disease (CHD). We have conducted a systematic review with meta-regression to identify the characteristics of psychological interventions that improve depression and depressive symptoms among people with CHD. METHODS: Searches of multiple electronic databases up to March 2012 were conducted, supplemented by hand-searching of identified reviews and citation tracing of eligible studies. Studies were included if they reported a randomized controlled trial of a psychological intervention for people with CHD and included depression as an outcome. Data on main effects and characteristics of interventions were extracted from eligible studies. Standardized mean differences (SMDs) were calculated for each study and pooled using random-effects models. Random-effects multivariate meta-regression was performed to identify treatment characteristics associated with improvements in depression. RESULTS: Sixty-four independent treatment comparisons were identified. Psychological interventions improved depression, although the effect was small (SMD = 0.18, p < .001). Problem solving (SMD = 0.34), general education (SMD = 0.19), skills training (SMD = 0.25), cognitive-behavioral therapy (CBT; SMD = 0.23), and relaxation (SMD = 0.15) had small effects on CHD patients who were recruited irrespective of their depression status. Among high-quality trials of depressed CHD patients, only CBT showed significant but small effects (SMD = 0.31). When entered into multivariable analysis, no individual treatment component significantly improved depression. CONCLUSIONS: CBT and problem solving should be considered for inclusion in future treatment developments and randomized controlled trials. However, the effects are small in magnitude, and there is room to develop new interventions that may be more effective.
机译：目的：尽管有先前的干预试验，但尚不清楚哪种心理治疗方法对冠心病（CHD）患者最有效。我们对荟萃回归进行了系统评价，以确定可改善冠心病患者抑郁和抑郁症状的心理干预措施的特征。方法：对截至2012年3月的多个电子数据库进行了搜索，并辅之以人工搜索已鉴定评论和符合条件的研究的引文追踪。如果他们报告了对冠心病患者进行心理干预的随机对照试验，并且包括抑郁作为结果，则包括研究。有关干预措施的主要作用和特征的数据是从符合条件的研究中提取的。为每项研究计算标准化均值（SMD），并使用随机效应模型汇总。进行随机效应多元回归分析，以鉴定与抑郁症改善相关的治疗特征。结果：确定了64个独立的治疗比较。心理干预改善了抑郁症，尽管效果很小（SMD = 0.18，p <.001）。解决问题（SMD = 0.34），通识教育（SMD = 0.19），技能培训（SMD = 0.25），认知行为疗法（CBT; SMD = 0.23）和放松（SMD = 0.15）对CHD患者的影响很小不管他们的抑郁状态如何。在抑郁的冠心病患者的高质量试验中，只有CBT表现出显着但很小的效果（SMD = 0.31）。当进入多变量分析时，没有单独的治疗成分可以显着改善抑郁症。结论：应考虑将CBT和问题解决纳入未来的治疗方案开发和随机对照试验中。但是，这种影响的程度很小，并且有可能开发出可能更有效的新干预措施。

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