Systematic review and meta-analysis of interventions for depression and anxiety in persons with multiple sclerosis

被引：121

作者：

Fiest, K. M. ^{[1
]}

Walker, J. R. ^{[2
]}

Bernstein, C. N. ^{[1
]}

Graff, L. A. ^{[2
]}

Zarychanski, R. ^{[1
,3
]}

Abou-Setta, A. M. ^{[3
]}

Patten, S. B. ^{[4
,5
]}

Sareen, J. ^{[6
]}

Bolton, J. M. ^{[6
]}

Marriott, J. J. ^{[1
]}

Fisk, J. D. ^{[7
,8
,9
]}

Singer, A. ^{[10
]}

Marrie, R. A. ^{[1
,11
]}

机构：

[1] Univ Manitoba, Dept Internal Med, Coll Med, Fac Hlth Sci, 820 Sherbrook St, Winnipeg, MB R3A 1R9, Canada

[2] Univ Manitoba, Dept Clin Hlth Psychol, Coll Med, Fac Hlth Sci, 771 Bannatyne Ave, Winnipeg, MB R3E 3N4, Canada

[3] Univ Manitoba, George & Fay Yee Ctr Hlth Care Innovat, 820 Sherbrook St, Winnipeg, MB R3A 1R9, Canada

[4] Univ Calgary, Cumming Sch Med, Dept Community Hlth Sci, 3280 Hosp Dr NW, Calgary, AB T2N 4Z6, Canada

[5] Univ Calgary, Cumming Sch Med, Dept Psychiat, 3280 Hosp Dr NW, Calgary, AB T2N 4Z6, Canada

[6] Univ Manitoba, Dept Psychiat, Coll Med, Fac Hlth Sci, 771 Bannatyne Ave, Winnipeg, MB R3E 3N4, Canada

[7] Dalhousie Univ, Dept Psychiat, 6299 South St, Halifax, NS B3H 4R2, Canada

[8] Dalhousie Univ, Dept Med, 6299 South St, Halifax, NS B3H 4R2, Canada

[9] Dalhousie Univ, Dept Psychol & Neurosci, 6299 South St, Halifax, NS B3H 4R2, Canada

[10] Univ Manitoba, Dept Family Med, 400 Tache Ave, Winnipeg, MB R2H 3E1, Canada

[11] Univ Manitoba, Dept Community Hlth Sci, Coll Med, 820 Sherbrooke St, Winnipeg, MB R3A 1R9, Canada

来源：

MULTIPLE SCLEROSIS AND RELATED DISORDERS | 2016年 / 5卷

基金：

加拿大健康研究院;

关键词：

Multiple sclerosis; Depression; Anxiety; Treatment; Systematic review; Meta-analysis; COGNITIVE-BEHAVIORAL THERAPY; QUALITY-OF-LIFE; ADJUSTMENT GROUP; CONTROLLED-TRIALS; SOCIAL SUPPORT; PSYCHOTHERAPY; EFFICACY; PEOPLE; DISORDERS; PHARMACOTHERAPY;

D O I：

10.1016/j.msard.2015.10.004

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Depression and anxiety are common in persons with multiple sclerosis (MS), and adversely affect fatigue, medication adherence, and quality of life. Though effective treatments for depression and anxiety exist in the general population, their applicability in the MS population has not been definitively established. Objective: To determine the overall effect of psychological and pharmacological treatments for depression or anxiety in persons with MS. Methods: We searched the Medline, EMBASE, PsycINFO, PsycARTICLES Full Text, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, and Scopus databases using systematic review methodology from database inception until March 25, 2015. Two independent reviewers screened abstracts, extracted data, and assessed risk of bias and strength of evidence. We included controlled clinical trials reporting on the effect of pharmacological or psychological interventions for depression or anxiety in a sample of persons with MS. We calculated standardized mean differences (SMD) and pooled using random effects meta-analysis. Results: Of 1753 abstracts screened, 21 articles reporting on 13 unique clinical trials met the inclusion criteria. Depression severity improved in nine psychological trials of depression treatment (N=307; SMD: -0.45 (95% CI: -0.74, -0.16)). The severity of depression also improved in three pharmacological trials of depression treatment (SMD: -0.63 (N=165; 95%CI: -1.07, -0.20)). For anxiety, only a single trial examined psychological therapy for injection phobia and reported no statistically significant improvement. Conclusion: Pharmacological and psychological treatments for depression were effective in reducing depressive symptoms in MS. The data are insufficient to determine the effectiveness of treatments for anxiety. (C) 2015 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org.licenses/by-nc-nd/4.0/).

引用

页码：12 / 26

页数：15

共 75 条

[51] Mental comorbidity and multiple sclerosis: validating administrative data to support population-based surveillance [J].

Marrie, Ruth Ann ;

Fisk, John D. ;

Yu, Bo Nancy ;

Leung, Stella ;

Elliott, Lawrence ;

Caetano, Patricia ;

Warren, Sharon ;

Evans, Charity ;

Wolfson, Christina ;

Svenson, Lawrence W. ;

Tremlett, Helen ;

Blanchard, James F. ;

Patten, Scott B. .

BMC NEUROLOGY, 2013, 13

[52] Evidence-based guideline: Assessment and management of psychiatric disorders in individuals with MS Report of the Guideline Development Subcommittee of the American Academy of Neurology [J].

Minden, Sarah L. ;

Feinstein, Anthony ;

Kalb, Rosalind C. ;

Miller, Deborah ;

Mohr, David C. ;

Patten, Scott B. ;

Bever, Christopher, Jr. ;

Schiffer, Randolph B. ;

Gronseth, Gary S. ;

Narayanaswami, Pushpa .

NEUROLOGY, 2014, 82 (02) :174-181

[53] The Sonya Slifka Longitudinal Multiple Sclerosis Study: methods and sample characteristics [J].

Minden, SL ;

Frankel, D ;

Hadden, L ;

Perloff, J ;

Srinath, KP ;

Hoaglin, DC .

MULTIPLE SCLEROSIS JOURNAL, 2006, 12 (01) :24-38

[54]

Moher D, 2015, SYST REV-LONDON, V4, DOI [10.1186/2046-4053-4-1, 10.1136/bmj.i4086, 10.1016/j.ijsu.2010.07.299, 10.1371/journal.pmed.1000097, 10.1136/bmj.b2700, 10.1136/bmj.b2535, 10.1016/j.ijsu.2010.02.007]

[55] Control condition design and implementation features in controlled trials: a meta-analysis of trials evaluating psychotherapy for depression [J].