心理疗法治疗创伤后应激障碍的系统评价
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摘要
目的系统评价心理疗法治疗创伤后应激障碍(Post traumatic stress disorder,PTSD)的研究现状和临床疗效。方法计算机检索Cochrane图书馆临床对照试验资料库(2011年第8期)、PubMed(1966～2011.8)、Embase(1974～2011.8)、中国期刊全文数据库(1994～2011.8)、CBM(1978～2011.8)、VIP(1989～2011.8)、中华医学会数字化期刊库(1998～2011.8)。由2位研究者独立进行资料提取和质量评估,所有数据用Excel和SPSS17.0进行统计分析。结果最终纳入22个临床研究,仅3个为RCT和1个为Q-RCT,4个(18.18%)和5个(22.73%)发表在SCI和CSCD收录的杂志上。19(86.36%)个研究以地震所致的PTSD患者为研究对象,其中15个为汶川大地震。7个研究明确报告采用认知行为治疗、暴露治疗等具体心理治疗方法进行干预,15个研究使用心理量表,但评价标准并不一致。结论目前有关心理干预手段治疗PTSD的研究数量少、质量偏低,部分研究未说明具体心理干预的措施且缺乏客观、标准的评估标准,尚缺乏心理干预手段治疗PTSD的高质量的研究证据。
OBJECTIVE To investigate psychotherapy for post-traumatic stress disorder(PTSD).METHODS The Cochrane Central Register of Controlled Trials(CENTRAL)(The Cochrane Library,Issue8,2011),PubMed(1966-2011.8),EMBASE(1974-2011.8),CNKI(1994-2011.8),VIP(1989-2011.8),and CMD Digital Periodicals(1998-2011.8)were searched.Two reviewers independently investigated the included studies and extracted the data.Analyses were performed by Excel and SPSS17.0.RESULTS Finally 22 researches were identified,including 3 RCTs and 1 Q-RCT.4(18.18%)studies were published and 5(22.73%)studies were published on journals recorded by SCI and CSCD.19(86.36%)researches forced on earthquake survivors,and 15 related to Wenchuan earthquake in 2008.7 researches definitely used cognitive behavioral therapy,exposure therapy and so on.15 researches used psychological scale with different evaluation standard.CONCLUSION Very few researches about psychotherapy for post-traumatic stress disorder(PTSD)are reported,and most of which are published with poor quality.There is no study evidence with high quality for psychotherapy for PTSD.
OBJECTIVE To investigate psychotherapy for post-traumatic stress disorder(PTSD).METHODS The Cochrane Central Register of Controlled Trials(CENTRAL)(The Cochrane Library,Issue8,2011),PubMed(1966-2011.8),EMBASE(1974-2011.8),CNKI(1994-2011.8),VIP(1989-2011.8),and CMD Digital Periodicals(1998-2011.8)were searched.Two reviewers independently investigated the included studies and extracted the data.Analyses were performed by Excel and SPSS17.0.RESULTS Finally 22 researches were identified,including 3 RCTs and 1 Q-RCT.4(18.18%)studies were published and 5(22.73%)studies were published on journals recorded by SCI and CSCD.19(86.36%)researches forced on earthquake survivors,and 15 related to Wenchuan earthquake in 2008.7 researches definitely used cognitive behavioral therapy,exposure therapy and so on.15 researches used psychological scale with different evaluation standard.CONCLUSION Very few researches about psychotherapy for post-traumatic stress disorder(PTSD)are reported,and most of which are published with poor quality.There is no study evidence with high quality for psychotherapy for PTSD.
引文
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[8]Baoglu M,Salcioglu E,Livanou M.A randomized controlled study of single-session behavioural treatment of earthquake-related posttraumatic stress disorder using an earthquake simulator[J].Psychol Med,2007,37(2):203-213.
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[10]Berger R,Gelkopf M.School-based intervention for the treatment of tsunami-related distress in children:a quasi-randomized controlled trial[J].Psychother Psychosom,2009,78(6):364-371.
[11]杨丽,阮冶,张勇辉,等.异地安置四川地震灾区学龄儿童的心理干预[J].四川精神卫生,2010,23(1):37-39.
[12]Baolu M,Livanou M,Salciolu E,et al.A brief behavioural treatment of chronic post-traumatic stress disorder in earthquake survivors:results from an open clinical trial[J].Psychol Med,2003,33(4):647-654.
[13]Chemtob CM,Nakashima J,Carlson JG.Brief treatment for elementary school children with disaster-related posttraumatic stress disorder:a field study[J].J Clin Psychol,2002,58(1):99112.
[14]刘艳,于秀,金丽.35名高龄地震伤骨折患者的心理反应及护理干预[J].西南军医,2008,10(5):32-33.
[15]高福美.54例灾后病人心理特征分析与心理干预[J].实用医技杂志,2008,15(26):3609-3610.
[16]刘贵浩,郭丽.地震后儿童创伤后应激障碍的症状及其治疗[J].中山大学学报:医学科学版,2008,29(6):649-653.
[17]胡利君,谢小华,龚敏,等.地震后赴外地治疗伤员及家属的心理干预效果评价[J].齐齐哈尔医学院学报,2009,30(14):1786-1787.
[18]华丽,郑红薇,万昌丽,等.地震后兴奋型创伤应激障碍的临床特征与护理[J].上海护理,2009,9(2):54-55.
[19]肖戈惠,曾登芬,喻红.地震伤员心理干预的护理体会[J].重庆医学,2008,37(18):2121-2122.
[20]叶彦琪.地震灾难事件伤员及家属的心理危机干预[J].黎明职业大学学报,2008,(3):70-74.
[21]王贵国,吴张鹏,李丽,等.对57名地震灾后伤员心理干预的体会[J].中华保健医学杂志,2008,10(5):389-390.
[22]张滢,冯斌,谢建平,等.认知行为疗法配合穴位刺激调控法治疗地震所致创伤后应激障碍临床研究[J].中医杂志,2009,50(6):513-515.
[23]李宗英.四川地震转诊伤员急性创伤后精神障碍的护理[J].齐齐哈尔医学院学报,2008,29(24):3061-3062.
[24]吴少怡,曹丽丽,王瑞.汶川地震后异地治疗伤员的心理干预[J].山东大学学报:医学版,2009,47(8):114-117.
[25]向虎,黄宣银,王荣科,等.汶川地震绵阳极重灾区心理危机干预纪实[J].中国循证医学杂志,2008,8(11):918-921.
[26]康霞,王凤英,谢国省.震后康复期青少年创伤后精神障碍的预防[J].华西医学,2009,24(3):555-557.
[27]Oflaz F,Hatipolu S,Aydin H.Effectiveness of psychoeducation intervention on post-traumatic stress disorder and coping styles ofearthquake survivors[J].J Clin Nurs,2008,17(5):677-687.
[28]Chemtob CM,Nakashima JP,Hamada RS.Psychosocial intervention for postdisaster trauma symptoms in elementary school children:a controlled community field study[J].Arch Pediatr Adolesc Med,2002,156(3):211-216.
[29]Lazaratou H,Paparrigopoulos T,Galanos G,et al.The psychological impact of a catastrophic earthquake:a retrospective study50years after the event[J].J Nerv Ment Dis,2008,196(4):340-344.
[2]李成齐.儿童创伤后应激障碍的症状表现与干预策略[J].中国特殊教育,2006,(6):88-91.
[3]贾福军.儿童创伤后应激障碍研究现状[J].中原精神医学学刊,2000,6(2):122-125.
[4]Madakasira S,O’brien KF.Acute posttraumatic stress disorder in victims of a natural disaster[J].J Nerv Ment Dis,1987,175(5):286-290.
[5]关念红,Wang Kun,魏钦令,等.汶川地震异地治疗伤员创伤后应激症状及影响因素分析[J].中山大学学报:医学科学版,2008,29(4):361-366.
[6]王相兰,陶炯,温盛霖,等.汶川地震灾民的心理健康状况及影响因素[J].中山大学学报:医学科学版,2008,29(4):367371.
[7]段艮芳,王健,周万明.综合心理护理干预对地震创伤手术患者康复的影响[J].中国循证医学杂志,2008,8(10):820-822.
[8]Baoglu M,Salcioglu E,Livanou M.A randomized controlled study of single-session behavioural treatment of earthquake-related posttraumatic stress disorder using an earthquake simulator[J].Psychol Med,2007,37(2):203-213.
[9]Baolu M,Salciolu E,Livanou M,et al.Single-session behavioral treatment of earthquake-related posttraumatic stress disorder:a randomized waiting list controlled trial[J].J Trauma Stress,2005,18(1):1-11.
[10]Berger R,Gelkopf M.School-based intervention for the treatment of tsunami-related distress in children:a quasi-randomized controlled trial[J].Psychother Psychosom,2009,78(6):364-371.
[11]杨丽,阮冶,张勇辉,等.异地安置四川地震灾区学龄儿童的心理干预[J].四川精神卫生,2010,23(1):37-39.
[12]Baolu M,Livanou M,Salciolu E,et al.A brief behavioural treatment of chronic post-traumatic stress disorder in earthquake survivors:results from an open clinical trial[J].Psychol Med,2003,33(4):647-654.
[13]Chemtob CM,Nakashima J,Carlson JG.Brief treatment for elementary school children with disaster-related posttraumatic stress disorder:a field study[J].J Clin Psychol,2002,58(1):99112.
[14]刘艳,于秀,金丽.35名高龄地震伤骨折患者的心理反应及护理干预[J].西南军医,2008,10(5):32-33.
[15]高福美.54例灾后病人心理特征分析与心理干预[J].实用医技杂志,2008,15(26):3609-3610.
[16]刘贵浩,郭丽.地震后儿童创伤后应激障碍的症状及其治疗[J].中山大学学报:医学科学版,2008,29(6):649-653.
[17]胡利君,谢小华,龚敏,等.地震后赴外地治疗伤员及家属的心理干预效果评价[J].齐齐哈尔医学院学报,2009,30(14):1786-1787.
[18]华丽,郑红薇,万昌丽,等.地震后兴奋型创伤应激障碍的临床特征与护理[J].上海护理,2009,9(2):54-55.
[19]肖戈惠,曾登芬,喻红.地震伤员心理干预的护理体会[J].重庆医学,2008,37(18):2121-2122.
[20]叶彦琪.地震灾难事件伤员及家属的心理危机干预[J].黎明职业大学学报,2008,(3):70-74.
[21]王贵国,吴张鹏,李丽,等.对57名地震灾后伤员心理干预的体会[J].中华保健医学杂志,2008,10(5):389-390.
[22]张滢,冯斌,谢建平,等.认知行为疗法配合穴位刺激调控法治疗地震所致创伤后应激障碍临床研究[J].中医杂志,2009,50(6):513-515.
[23]李宗英.四川地震转诊伤员急性创伤后精神障碍的护理[J].齐齐哈尔医学院学报,2008,29(24):3061-3062.
[24]吴少怡,曹丽丽,王瑞.汶川地震后异地治疗伤员的心理干预[J].山东大学学报:医学版,2009,47(8):114-117.
[25]向虎,黄宣银,王荣科,等.汶川地震绵阳极重灾区心理危机干预纪实[J].中国循证医学杂志,2008,8(11):918-921.
[26]康霞,王凤英,谢国省.震后康复期青少年创伤后精神障碍的预防[J].华西医学,2009,24(3):555-557.
[27]Oflaz F,Hatipolu S,Aydin H.Effectiveness of psychoeducation intervention on post-traumatic stress disorder and coping styles ofearthquake survivors[J].J Clin Nurs,2008,17(5):677-687.
[28]Chemtob CM,Nakashima JP,Hamada RS.Psychosocial intervention for postdisaster trauma symptoms in elementary school children:a controlled community field study[J].Arch Pediatr Adolesc Med,2002,156(3):211-216.
[29]Lazaratou H,Paparrigopoulos T,Galanos G,et al.The psychological impact of a catastrophic earthquake:a retrospective study50years after the event[J].J Nerv Ment Dis,2008,196(4):340-344.
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