将心理治疗纳入超重/肥胖干预对青少年体重状况和抑郁症状的影响:一项叙述性综述

Rohina Kumar, Genevieve Ramnarine
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引用次数: 0

摘要

儿童肥胖和青少年抑郁是21世纪严重的全球性危机。许多研究人员经常把这归因于它们之间根深蒂固的联系。因此,心理治疗越来越多地被纳入干预措施,以改善超重和/或肥胖(OW/OB)个体的体重状况和抑郁结局。然而,这些干预措施对患有OW/OB的青少年的有效性尚未得到审查。这样的年轻人往往更容易出现共病性抑郁症状,这种症状可能会持续到成年。因此,本叙述性综述探讨了心理治疗整合OW/OB干预对青少年体重状况和抑郁症状的有效性。方法:检索Medline、Embase、PsycInfo、PubMed、Scopus。我们纳入了过去10年的英文同行评议的实证文章、综述、荟萃分析、临床试验和试点研究,以及那些调查青少年(5-18岁)OW/OB干预与心理治疗相结合的有效性的研究。关键词:饮食、心理治疗、OW/OB、青年、抑郁。非同行评议的来源、方法缺乏足够透明度的评论、社论、信函、研究方案、评论、预印本和论文被排除在外。结果:纳入4项研究,包括2项先导研究。总的来说,我们发现他们的干预成分和条件、研究设计、参与者和结果具有很高的异质性。在青少年中,根据作者设定的显著性阈值,所有研究都没有发现体重状况有显著改善。对青少年抑郁症状的影响得到了不同的结果。讨论:关于在OW/OB干预中综合循证心理治疗对青少年体重状况和抑郁症状的影响,最近的文献缺乏,令人担忧。重要的是要调查它们在为OW/OB青少年提供持续改变生活方式和应对体重歧视和抑郁症状的技能方面的有效性。我们将这些干预措施的微弱成功归因于缺乏文化适应和研究类型、干预结构、组成部分和条件的标准化。结论:对于研究人员来说,继续研究这些干预措施对同时患有OW/OB的青少年的身体和心理结果的成功是很重要的。这将进一步为向这些青年提供适当照顾所需的跨学科方法提供信息。
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The Effectiveness of Integrating Psychotherapy Into Overweight/Obesity Interventions on Youth’s Weight Status and Depressive Symptoms: A Narrative Review
Introduction: Childhood obesity and youth depression are serious ongoing global crises of the 21st century. Many researchers have often attributed this to the well-established association between them. Consequently, psychotherapies are increasingly being integrated into interventions to improve weight status and depression outcomes for individuals with overweight and/or obesity (OW/OB). However, the effectiveness of these interventions has not yet been reviewed for youth with OW/OB. Such youth tend to be at a higher risk of developing comorbid depressive symptoms, which can likely persist into adulthood. Therefore, this narrative review explored the effectiveness of psychotherapy integrations within OW/OB interventions on youth’s weight statuses and their depressive symptoms contemporaneously. Methods: Medline, Embase, PsycInfo, PubMed, and Scopus were accessed. English peer-reviewed empirical articles, reviews, meta-analyses, clinical trials, and pilot studies from the last ten years and those that investigated the effectiveness of OW/OB interventions integrated with psychotherapy among youth (5-18 years) were included. Keywords related to diet, psychotherapy, OW/OB, youth, and depression were used. Non-peer-reviewed sources, reviews lacking sufficient transparency in their methodology, editorials, letters, study protocols, commentaries, preprints, and dissertations were excluded. Results: Four studies, including two pilot studies, were included. Overall, we found high heterogeneity in their intervention components and conditions, study designs, participants, and results. Among youth, all studies found no significant improvements in weight status as per the authors’ set significance thresholds. Mixed results were obtained for the effect on youth’s depressive symptoms. Discussion: There is an alarming lack of recent literature investigating the impact of integrated evidence-based psychotherapies within OW/OB interventions on youth’s weight statuses and depressive symptoms. It is important to investigate their effectiveness in equipping youth with OW/OB with skills to make sustained lifestyle changes and cope with weight discrimination and depressive symptoms. We attributed the weak success of these interventions to the lack of cultural adaptations and standardization of study types, intervention structures, components, and conditions. Conclusion: It is important for researchers to continue investigating the success of such interventions on youth with OW/OB’s physical and mental outcomes simultaneously. This will further inform the interdisciplinary approach needed to deliver appropriate care to these youth.
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