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抑郁症查和心血管护理中的患者结果:系统性审查
Brett D Thombs1, Peter de Jonge, James C Coyne
1Department of Psychiatry, McGill University, Montréal, Québec, Canada. brett.thombs@mcgill.ca
JAMA
|November 13, 2008
概括
心血管疾病患者的抑郁症查显示,随着治疗,症状有所改善,但对心脏没有益处. 临床试验尚未评估查对患者结果的影响.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 基于证据的医学是基于证据的医学.
背景情况:
- 实践指南建议对心血管疾病 (CVD) 患者进行抑郁症评估和治疗.
- 这种方法对心血管疾病患者的实际益处尚不清楚.
研究的目的:
- 评估心血管疾病患者抑郁查的好处.
- 评估选仪器的准确性.
- 确定抑郁症治疗对抑郁症和心脏结果的影响.
- 检查查对抑郁症和心脏病结果的影响.
主要方法:
- 对多个数据库 (MEDLINE,PsycINFO等) 的系统审查. 以及手动搜索.
- 包括的研究比较了查工具与标准标准,抑郁症治疗与安慰剂/常规护理,或评估了查效应.
- 数据由两个独立的调查人员提取.
主要成果:
- 11项研究评估了查准确度 (中位敏感度84%,特异性79%).
- 6项试验显示,抑郁症治疗 (药物治疗,CBT) 适度减少了抑郁症状 (效果大小为0.20-0.38).
- 没有证据表明抑郁症治疗改善了心脏结果;查对结果的影响没有研究.
结论:
- 对心血管疾病患者的抑郁症治疗可以改善抑郁症症状,但不能改善心脏病的结果.
- 没有任何临床试验评估过抑郁查对该人群抑郁或心脏结果的影响.
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