Effect of psychosocial interventions on social functioning in depression and schizophrenia: meta-analysis.
Effect of psychosocial interventions on social functioning in depression and schizophrenia: meta-analysis.
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DOI：
10.1192/bjp.bp.112.118018
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发表时间：
2013-04
期刊：
影响因子：
--
通讯作者：
Patel V
中科院分区：
文献类型：
--
作者：
De Silva MJ;Cooper S;Li HL;Lund C;Patel V
社会心理干预可能有助于通过改善社会功能来减轻中低收入国家的精神障碍负担，但尚未对证据进行系统性审查。 目的：对LAMI国家的抑郁症和精神分裂症患者的社会功能进行社会心理干预效果的系统评价和荟萃分析。 方法通过数据库检索确定研究，截至2011年3月。如果随机对照试验将干预组与接受安慰剂或常规治疗的对照组进行比较，则将其纳入。对抑郁症和精神分裂症以及每种干预类型分别进行随机效应荟萃分析。 结果符合纳入标准的研究（n = 24）中，21项有足够的数据纳入荟萃分析。11项抑郁症试验显示了良好的证据，表明心理社会干预对社会功能有中度积极影响（标准化均值差（SMD）= 0.46，95%CI 0.24-0.69，n = 4009），10项精神分裂症试验显示对社会功能有很大的积极影响（SMD = 0.84，95% CI 0.49-1.19，n = 1671），尽管其中7项试验质量较低。排除这些因素并未显著影响效应的大小或方向，但估计值的精密度显著降低（SMD = 0.89，95% CI 0.05-1.72，n = 863）。 结论：在门诊和初级保健环境中提供的心理社会干预措施可有效改善抑郁症患者的社会功能，应纳入扩大服务的努力。对于精神分裂症，缺乏来自高质量试验的证据，并且由于在中国医院患者人群中进行的试验代表性过高，结果的普遍性受到限制。需要更多高质量的精神分裂症门诊心理社会干预试验。
Background Psychosocial interventions may contribute to reducing the burden of mental disorders in low- and middle-income (LAMI) countries by improving social functioning, but the evidence has not been systematically reviewed. Aims Systematic review and meta-analysis of the effect of psychosocial interventions on social functioning in people with depression and schizophrenia in LAMI countries. Method Studies were identified through database searching up to March 2011. Randomised controlled trials were included if they compared the intervention group with a control group receiving placebo or treatment as usual. Random effects meta-analyses were performed separately for depressive disorders and schizophrenia and for each intervention type. Results Of the studies that met the inclusion criteria (n = 24), 21 had sufficient data to include in the meta-analysis. Eleven depression trials showed good evidence for a moderate positive effect of psychosocial interventions on social functioning (standardised mean difference (SMD) = 0.46, 95% CI 0.24–0.69, n = 4009) and ten schizophrenia trials showed a large positive effect on social functioning (SMD = 0.84, 95% CI 0.49–1.19, n = 1671), although seven of these trials were of low quality. Excluding these did not substantially affect the size or direction of effect, although the precision of the estimate was substantially reduced (SMD = 0.89, 95% CI 0.05–1.72, n = 863). Conclusions Psychosocial interventions delivered in out-patient and primary care settings are effective at improving social functioning in people with depression and should be incorporated into efforts to scale up services. For schizophrenia there is an absence of evidence from high-quality trials and the generalisabilty of the findings is limited by the over-representation of trials conducted in populations of hospital patients in China. More high-quality trials of psychosocial interventions for schizophrenia delivered in out-patient settings are needed.
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影响因子：
--
作者：
Guo, Xiaofeng;Zhai, Jinguo;Liu, Zhening;Fang, Maosheng;Wang, Bo;Wang, Chuanyue;Hu, Bin;Sun, Xueli;Lv, Luxian;Lu, Zheng;Ma, Cui;He, Xiaolin;Guo, Tiansheng;Xie, Shiping;Wu, Renrong;Xue, Zhimin;Chen, Jindong;Twamley, Elizabeth W.;Jin, Hua;Zhao, Jingping
通讯作者：
Zhao, Jingping
影响因子：
15.8
作者：
Dua T;Barbui C;Clark N;Fleischmann A;Poznyak V;van Ommeren M;Yasamy MT;Ayuso-Mateos JL;Birbeck GL;Drummond C;Freeman M;Giannakopoulos P;Levav I;Obot IS;Omigbodun O;Patel V;Phillips M;Prince M;Rahimi-Movaghar A;Rahman A;Sander JW;Saunders JB;Servili C;Rangaswamy T;Unützer J;Ventevogel P;Vijayakumar L;Thornicroft G;Saxena S
通讯作者：
Saxena S
影响因子：
168.9
作者：
Kakuma, Ritsuko;Minas, Harry;Scheffler, Richard M.
通讯作者：
Scheffler, Richard M.
影响因子：
120.7
作者：
Bolton, P;Bass, J;Weissman, M
通讯作者：
Weissman, M
影响因子：
168.9
作者：
Araya, R;Rojas, G;Peters, TJ
通讯作者：
Peters, TJ