Meta-analysis of cognitive-behavioral interventions on HIV-positive persons' mental health and immune functioning
Meta-analysis of cognitive-behavioral interventions on HIV-positive persons' mental health and immune functioning
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DOI：
10.1037/0278-6133.27.1.4
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发表时间：
2008-01-01
影响因子：
4.2
通讯作者：
Wolitski, Richard J.
中科院分区：
文献类型：
--
作者：
Crepaz, Nicole;Passin, Warren F.;Wolitski, Richard J.
目的：评价认知行为干预（CBIs）对改善艾滋病病毒感染者（PLWH）心理健康和免疫功能的有效性。设计图：全面检索1988年至2005年的电子数据库，手工检索期刊，参考文献列表，与研究人员的联系。在综合研究结果时采用了荟萃分析方法。主要观察指标：评估干预对抑郁、焦虑、愤怒、压力和CD4细胞计数的影响。结果：分析了15个对照试验的数据。干预后抑郁（d = 0.33）、焦虑（d = 0.30）、愤怒（d = 1.00）、紧张（d = 0.43）症状均有显著改善。有有限的证据表明干预对CD4细胞计数的影响（d = 0.08）。在提供压力管理技能培训并进行10次以上干预的试验中，抑郁和焦虑的总效应量估计值具有统计学意义。结论：CBIs对改善PLWH患者的各种心理状态有一定疗效。未来的研究应检查干预措施，心理状态，药物依从性和免疫功能之间的关系，并确定与干预效果相关的其他相关因素。
Objective: To evaluate the efficacy of cognitive-behavioral interventions (CBIs) for improving the mental health and immune functioning of people living with HIV (PLWH). Design: Comprehensive searches of electronic databases from 1988 to 2005, hand searches of journals, reference lists of articles, and contacts with researchers. Meta-analytic approaches were used in synthesizing findings. Main Outcome Measures: Intervention effects on symptoms of depression, anxiety, and anger, stress, and CD4 cell counts were assessed. Results: Data from 15 controlled trials were analyzed. Significant intervention effects were observed for improving symptoms of depression (d = 0.33), anxiety (d = 0.30), anger (d = 1.00), and stress (d = 0.43). There is limited evidence suggesting intervention effects on CD4 cell counts (d = 0.08). The aggregated effect size estimates for depression and anxiety were statistically significant in trials that provided stress management skills training and had more than 10 intervention sessions. Conclusion: CBIs are efficacious in improving various psychological states of PLWH. Future research should examine the relationship among interventions, psychological states, medication adherence, and immune functions, and identify other relevant factors associated with intervention effects.