双相情感障碍认知补救的有效性:随机对照试验的系统审查和元分析
Cecilia Samamé1,2, Paula Durante3, Brenda Cattaneo3
1Universidad Católica del Uruguay, Montevideo, Uruguay.
Psychological medicine
|July 24, 2023
概括
认知补救 (CR) 适度改善双相情感障碍 (BD) 患者的工作记忆等认知功能. 然而,这些认知收益并没有转化为功能恢复,质疑CR.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
背景情况:
- 双极性障碍 (BD) 通常会导致显著的功能障碍,即使在治疗和症状缓解的情况下.
- 认知缺陷与BD患者的社会职业结果差以及生活质量降低密切相关.
- 认知补救 (CR) 被探索为一种潜在的干预措施,以改善BD的功能恢复.
研究的目的:
- 系统地审查和元分析认知补救 (CR) 方法在改善双相情感障碍 (BD) 患者认知和功能结果方面的有效性.
- 评估CR干预是否导致BD患者认知表现和功能调整的可衡量的改善.
主要方法:
- 在PubMed,PsycINFO和CENTRAL数据库进行了系统的搜索,直到2022年11月.
- 包括随机对照试验 (RCT),评估CR对成年BD患者认知和/或功能的影响.
- 超分析程序结合了来自7项涉及586名参与者的独立试验的效果大小 (Hedges' g).
主要成果:
- 在工作记忆 (g = 0.32),计划 (g = 0.30) 和口头学习 (g = 0.40) 中发现了小但统计学上显著的改善.
- 没有观察到CR对功能结果的显著影响,无论是治疗后立即还是随访时.
- 通过CR实现的认知增强并没有转化为BD患者的有形功能改善.
结论:
- 虽然CR在双相情感障碍中对特定的认知领域产生了适度的积极影响,但目前还没有导致功能恢复.
- 观察到的CR的认知益处似乎不适用于现实世界的功能调整.
- 目前的证据不支持在临床实践指南中定期将认知补救纳入治疗双相情感障碍的临床实践指南.
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