预防老年抑郁症复发的最佳证据总结  

Summary of Best Evidence for Prevention of Recurrence of Late-life Depression

作　　者：查倩倩 徐莲英 陈娟[1] 黄闻 章新琼[2] ZHA Qianqian;XU Lianying;CHEN Juan;HUANG Wen;ZHANG Xinqiong(Affiliated Psychological Hospital of Anhui Medical University/Anhui Mental Health Center,Hefei 230032,China;School of Nursing,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学附属心理医院安徽省精神卫生中心,安徽省合肥市230032 [2]安徽医科大学护理学院,安徽省合肥市230032

出　　处：《中国全科医学》2023年第19期2332-2338,共7页Chinese General Practice

基　　金：国家重点研发计划项目(2020YFC2008802);2018年省级校企合作项目(2018sjjd056);合肥市第四人民医院科研项目(HFSY202116)。

摘　　要：背景老年抑郁症复发率高,但目前国内外较缺乏预防老年抑郁症复发干预方案的研究。课题组前期探究了老年抑郁症复发的危险因素,其中可控性危险因素为服药依从性差、活动少、进食少。目的 根据以上3个危险因素检索、评价和总结预防老年抑郁症复发的相关证据。方法 2022年10月,计算机检索Web of Science、PubMed、Cochrane Library、美国指南网、英国指南库、加拿大安大略护理学会网站(RNAO)、复旦大学循证护理中心、中国知网等数据库,收集关于预防老年抑郁症和老年疾病伴发抑郁症复发方面的相关证据,包括指南、系统评价、专家共识、证据总结等,检索时限为从建库至2022年10月。由接受过循证医学系统培训的研究者分别采用临床指南研究与评估系统Ⅱ(AGREEⅡ)、AMSTAR、澳大利亚乔安娜布里格斯研究所(JBI)循证中心评价标准(2016版)对纳入的指南、系统评价、专家共识和原始研究进行质量评价。最后采用2014年澳大利亚版本JBI循证卫生保健中心证据分级及证据推荐级别系统进行证据汇总、评价和等级划分。结果 共纳入15篇文献,包括指南3篇、系统评价11篇、随机对照试验1篇。纳入的3篇指南文献质量评价均为B级及以上,11篇系统评价文献质量评价均为中等质量及以上,1篇随机对照试验质量等级评定为B级。分别从干预评估、饮食与营养、运动与康复训练、社会心理干预、服药依从性、效果评价6个方面共汇总24条最佳证据。结论 本研究总结了预防老年抑郁症复发的最佳证据,提示临床医护人员应全面评估患者,并结合患者和其疾病的特点,围绕评估、饮食与营养、运动与康复训练、服药依从性指导、社会心理干预等内容制定个体化干预方案。Background The recurrence rate of late-life depression is high,however,there is a lack of research on intervention protocol to prevent recurrence of late-life depression at home and abroad.In the early stage,the research group explored the risk factors for recurrence of late-life depression,and the controllable risk factors were poor medication compliance,less physical activity,and less eating.Objective To search,evaluate and summarize the evidence related to the prevention of recurrence of late-life depression based on the above three risk factors.Methods In October 2022,the evidences related to the prevention of recurrence of late-life depression were searched in Web of Science,Pub Med,Cochrane Library,American Guide Network,British Guidebook,Website of Registered Nurses Association of Ontario(RNAO),Evidence-based Nursing Center of Fudan University,CNKI and other databases from inception to October 2022,which include guidelines,systematic reviews,expert consensuses,evidence summaries,etc.The quality of the included guidelines,systematic reviews,expert consensuses and original researches were evaluated by investigators trained in systematic evidence-based medicine using the Appraisal of Guidelines for Research Evaluation Ⅱ(AGREE Ⅱ) Instrument,AMSTAR,and the Australian Joanna Briggs Institute(JBI) evidence-based center evaluation standards(2016 version),respectively.Finally,the 2014 Australian JBI evidence-based health care center evidence grading and recommendation level system was used to summary,evaluate and grade the evidence.Results A total of 15 articles were included,including 3 guidelines,11 systematic reviews and 1 RCT.The qualities of the 3 guidelines were graded as B or above,the qualities of 11 systematic reviews were graded as medium or above,and the quality of 1 RCT was graded as B.A total of 24 best evidence items were summarized from 6 aspects of intervention evaluation,diets and nutrition,exercise and rehabilitation training,psychosocial interventions,medication compliance,and effect evaluati

关 键 词：抑郁症 复发 老年人 老年人保健服务 循证医学 

分 类 号：R749.41[医药卫生—神经病学与精神病学]