摘要
目的:采用系统评价和meta分析的方法评估认知行为治疗(CBT)对自杀意念和自杀行为的疗效。方法:计算机检索Pub Med、PsycINFO、Cochrane图书馆、万方数据库、CNKI发表的CBT用于自杀意念和自杀行为者疗效比较的随机对照研究,主要结局为自杀意念的变化或消除,次要结局为自杀和自伤行为、抑郁症状。用Cochrane协作网研究偏倚风险评价工具评估研究质量,采用随机效应模型,使用RevM an 5. 3软件进行数据合并和分析。结果:共纳入19篇文献2707名患者。CBT可短期降低自杀意念(SMD=-0. 30,95%CI=-0. 42～-0. 19); CBT对自杀意念的中期和长期疗效和对照组无差异(SMD=-0. 27、-0. 18,95%CI:-0. 61～0. 07、-0. 41～0. 05)。CBT对自杀和自伤行为的短期、中期和长期疗效均优于对照组(OR=0. 68、0. 73、0. 50,95%CI=0. 48～0. 97、0. 54～0. 98、0. 31～0. 80)。CBT对抑郁症状短期、中期和长期疗效均优于对照组(SMD=-0. 35、-0. 28、-0. 35,95%CI=-0. 51～-0. 19、-0. 51～-0. 05、-0. 55～-0. 15)。结论:短期内认知行为治疗可以降低自杀意念;认知行为治疗也能减少自杀和自伤行为风险,改善与自杀相关的抑郁情绪。
Objective:To evaluate the effect of cognitive behavioral therapy( CBT) on suicidal ideation and suicidal behavior in a systematic review and meta-analysis.Methods:PubMed,PsycINFO,Cochrane library,Wanfang Data,CNKI were searched for randomized controlled trials( RCT) of CBT treatment suicidal ideation and behavior.The primary outcome was changes and elimination in suicidal ideation and the second outcomes were suicidal behavior and self-harm behavior,depressive symptoms.The risk of bias was assessed with the Cochrane risk of bias tool.Random-effects models were used to calculate pooled mean difference estimates by RevMan 5.3.Results:Nineteen RCT( 2707 participants) were included.For suicidal ideation,CBT was significantly effective than control group in the short-term( SMD =-0.30,95% CI =-0.42--0.19),but not in medium-term or in long-term( SMD =-0.27,-0.18;95% CI =-0.61-0.07,-0.41-0.05).In terms of suicidal behavior and self-harm,CBT was better than control group in short-term,medium-term and long-term( OR = 0.68,0.73,0.50;95% CI =0.48-0.97,0.54-0.98,0.31-0.80).In terms of depressive symptoms,CBT was better than control group in short,medium and long-term( SMD =-0.35,-0.28,-0.35;95% CI =-0.51--0.19,-0.51--0.05,-0.55--0.15).Conclusion:Cognitive behavioral therapy( CBT) may be effective in suicidal ideation in shortterm.CBT could decrease the risk of suicidal behavior and self-harm,and improve depressive symptoms.
作者
张迎黎
冯飞
梁炜
方莉
周云飞
位照国
刘铁榜
ZHANG Yingli;FENG Fei;LIANG Wei;FANG Li;ZHOU Yunfei;WEI Zhaoguo;LIU Tiebang(Shenzhen Kangning Hospital,Shenzhen Mental Health Center,Shenzhen 518020,Guangdong Province,China)
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2019年第1期8-14,共7页
Chinese Mental Health Journal
基金
深圳市科技创新委员会项目(基20170230)(JCYJ20170413101017457)
关键词
认知行为治疗
自杀
自杀意念
自伤行为
META分析
cognitive behavioral therapy
suicide
suicidal ideation
self-harm behavior
meta-analysis
