ISSN 1671-3710
CN 11-4766/R
主办：中国科学院心理研究所
出版：科学出版社

心理科学进展 ›› 2016, Vol. 24 ›› Issue (2): 173-195.doi: 10.3724/SP.J.1042.2016.00173

• 元分析 • 上一篇    下一篇

失眠的自助式认知行为治疗元分析：疗效、影响因素及证据评价

任志洪1,2,3;谢菲1,5;余香莲4;苏文亮1;陈丽君1;赵陵波1   

  1. (1福州大学人文社会科学学院, 福州 350108) (2青少年网络心理与行为教育部重点实验室,
    湖北省人的发展与心理健康重点实验室, 武汉 430079) (3中国科学院心理健康重点实验室, 北京 100101)
    (4福建师范大学海外教育学院, 福州 350108) (5 Department of Psychosis Studies; Institute of Psychiatry, Psychology & Neuroscience (IoPPN) ; King's College London, UK)
  • 收稿日期:2015-07-27 出版日期:2016-02-15 发布日期:2016-02-15
  • 通讯作者: 赵陵波, E-mail: zlb@fzu.edu.cn
  • 基金资助:

    教育部人文社会科学研究青年基金(12YJCZH170), 全国教育科学“十二五”规划教育部重点课题(DEA130237),青少年网络心理与行为教育部重点实验室, 中国科学院心理健康重点实验室, 积极教育研究基金(清华大学)和福建省高校杰出青年科研人才培育计划基金的资助。

A meta-analysis of self-help cognitive behavioral therapy for insomnia: Efficacy, influential factors and the quality of evidence

REN Zhihong1,2,3; XIE Fei1,5; YU Xianglian4; SU Wenliang1; CHEN Lijun1; ZHAO Lingbo1   

  1. (1 School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108 China)
    (2 Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education,
    Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan 430079 China)
    (3 Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101 China)
    (4 International College of Chinese School, Fujian Normal University, Fuzhou 350108 China) (5 Department of Psychosis Studies; Institute of Psychiatry, Psychology & Neuroscience (IoPPN); King's College London, UK)
  • Received:2015-07-27 Online:2016-02-15 Published:2016-02-15
  • Contact: ZHAO Lingbo, E-mail: zlb@fzu.edu.cn

PDF (PC)

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摘要：

通过元分析评估自助式失眠认知行为治疗的疗效, 考察疗效影响因素, 并评价证据质量。元分析共纳入35篇文献, 研究发现：(1)自助式失眠认知行为治疗在治疗结束时对睡眠效率、入睡潜伏期、入睡后醒来时长、睡眠总时间、睡眠质量、抑郁和焦虑的效果量分别为0.66、−0.52、−0.47、0.20、0.34、−0.32和−0.33。(2)自助式失眠认知行为治疗与面对面失眠认知行为治疗疗效同等; 自助式失眠认知行为治疗疗效显著优于最小化治疗和药物治疗。(3)共病情况与支持形式对疗效有显著影响。证据质量评价表明睡眠效率、入睡后醒来时长、睡眠总时间、抑郁和焦虑5项指标的证据质量为中等, 真实值可能接近于估计值; 入睡潜伏期与睡眠质量为低, 真实值与估计值可能存在着差异。

关键词: 失眠, 认知行为疗法, 元分析, 自助治疗

Abstract:

This meta-analysis evaluated the efficacy of Self-Help Cognitive Behavioral Therapy for Insomnia (SH-CBTI), explored potential moderators of treatment outcome and evaluated the quality of evidence. Thirty five studies were included, and results showed: (a) The immediate efficacies of SH-CBTI for SE, SOL, WASO, TST, SQ, depression and anxiety were 0.66, −0.52, −0.47, 0.20, 0.34, −0.32 and −0.33 respectively; (b) SH-CBTI and face-to-face CBTI showed an equal efficacy at post-treatment while both minimal treatment and pharmacotherapy showed significantly smaller effects; (c) Comorbidities and support formats had a significant impact on the outcome. Evaluation on the quality of evidence showed that qualities of SE, WASO, TST, depression and anxiety are moderate, which means that the true effect is likely to be close to the estimated one. Low-level evidence supports SOL and SQ qualities, which indicates that the true effect may be substantially different from the estimated one.

Key words: insomnia, cognitive behavioral, meta-analysis, self-help