精神分裂症超高危人群的早期心理干预与精神分裂症转化关系的meta分析  

A meta-analysis of relationship between early psychological intervention and schizophrenia conversion in ultra high-risk population

作　　者：张思宇 周郁秋[1] 王正君 王伟梁 姜丹 曲萍 ZHANG Siyu;ZHOU Yuqiu;WANG Zhengjun;WANG Weiliang;JIANG Dan;QU Ping(Harbin Medical University(Daqing)School of Nursing,Daqing 163319,Heilongjiang Province,China;Harbin First Special Hospital(Baiyupao),Harbin 150000,China)

机构地区：[1]哈尔滨医科大学(大庆)护理学院,黑龙江大庆163319 [2]哈尔滨市第一专科医院白渔泡分院,哈尔滨150000

出　　处：《中国心理卫生杂志》2021年第4期290-299,共10页Chinese Mental Health Journal

基　　金：国家自然科学基金面上项目--内蒙古贫困农牧区精神分裂症残疾危险因素评估及时点匹配干预与健康管理模式构建及评价(71673070)。

摘　　要：目的:评估精神分裂症超高危人群的早期心理干预对于精神分裂症转化及精神症状相关结局的影响。方法:计算机检索Cochrane Library、PubMed、EMBASE、中国知网、万方、维普数据库。收集从建库至2020年5月公开发表的有关超高危人群与精神分裂症转化等结局指标的研究,应用Revman 5.3软件进行meta分析。结果:共纳入文献11篇,包含10项研究,累积研究对象865例,其中心理干预组443例,对照组422例。Meta分析结果显示,早期心理干预可降低超高危人群短期、中期及远期精神分裂症转化率(RR=0.33、0.43、0.45,95%CI:0.20~0.55、0.28~0.65、0.29~0.70),改善阳性症状(SMD=-0.83、-0.34、-0.27,95%CI:-1.39~-0.28、-0.56~-0.11、-0.51~-0.03),但在阴性症状(SMD=-0.10、-0.14、-0.19,95%CI:-0.33~0.12、-0.40~0.11、-0.43~0.05)、抑郁症状(SMD=0.22、-0.07、-0.11,95%CI:-0.35~-0.78、-0.36~0.22、-0.41~0.20)、焦虑症状(MD=-2.11、-0.32、1.36,95%CI:-6.32~2.09、-4.58~3.93、-3.15~5.87)的改善方面两组差异无统计学意义(均P>0.05)。结论:早期心理干预可以降低超高危人群转化为精神分裂症的风险,改善阳性症状。Objective:To evaluate the effect of early psychological intervention on schizophrenia conversion and psychiatric symptoms in ultra high-risk for psychosis population.Methods:Cochrane Library, PubMed, EMBASE,CNKI,WangFang Database, VIP Database were systematically and independently searched by two authors.Studies on ultra high-risk for psychosis and schizophrenia conversion and other outcome indicators were searched from database established to May 2020.The meta-analysis was performed by using Revman 5.3 software.Results:A total of 11 articles about 10 studies were included, and 865 cases were studied, including 443 cases in psychological intervention groups and 422 cases in control groups.Meta-analysis showed that there were statistically significant differences in schizophrenia conversion(RR=0.33,0.43,0.45;95%CI:0.20-0.55,0.28-0.65,0.29-0.70)and positive symptoms(SMD=-0.83,-0.34,-0.27;95%CI:-1.39--0.28,-0.56--0.11,-0.51--0.03),between psychological intervention groups and control groups of ultra high-risk for psychosis population.However, there was no significant difference between the two groups in negative symptoms(SMD=-0.10,-0.14,-0.19;95%CI:-0.33-0.12,-0.40-0.11,-0.43-0.05),depression symptoms(SMD=0.22,-0.07,-0.11;95%CI:-0.35--0.78,-0.36-0.22,-0.41-0.20)and anxiety symptoms(MD=-2.11,-0.32,1.36;95%CI:-6.32-2.09,-4.58-3.93,-3.15-5.87)(P>0.05).Conclusion:It suggests that early psychological intervention could reduce the risk of conversion to schizophrenia and improve the severity of positive symptoms in ultra high-risk population.

关 键 词：心理干预 超高危 精神分裂症 META分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R739.305.5[医药卫生—临床医学]