{"title":"日记在精神疾病管理中的作用：系统综述和荟萃分析","authors":"Monika Sohal, Pavneet Singh, Bhupinder Singh Dhillon, Harbir Singh Gill","doi":"10.1136/fmch-2021-001154","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Journaling is a common non-pharmacological tool in the management of mental illness, however, no clear evidence-based guideline exists informing primary care providers on its use. We seek here to present this synthesis that may begin to inform future research and eventual evidence-based guideline development.</p><p><strong>Design: </strong>Of the 3797 articles retrieved from MEDLINE, EMBASE, PsycINFO, 20 peer-reviewed randomised control trials (31 outcomes) met inclusion criteria. These studies addressed the impact of a journaling intervention on PTSD, other anxiety disorders, depression or a combination of the aforementioned.</p><p><strong>Eligibility criteria: </strong>Peer reviewed, randomised control trials on the impact of journaling on mental illness were included.</p><p><strong>Information sources: </strong>MEDLINE, EMBASE and PsycINFO.</p><p><strong>Results: </strong>The data are highly heterogeneous (control arm=I<sup>2</sup> of 71.2%, intervention arm=I<sup>2</sup> of 83.8%) combined with a B-level Strength of Recommendation Taxonomy recommendation. It was additionally found that there is a significant pre-post psychometric scale difference between control (-0.01, 95% CI -0.03 to 0.00) and intervention arms (-0.06, 95% CI -0.09 to -0.03). This 5% difference between groups indicates that a journaling intervention resulted in a greater reduction in scores on patient health measures. Cohen's d effect size analysis of studies suggests a small to moderate benefit.</p><p><strong>Conclusion: </strong>Further studies are needed to better define the outcomes. Our review suggests that while there is some randomised control data to support the benefit of journaling, high degrees of heterogeneity and methodological flaws limit our ability to definitively draw conclusions about the benefit and effect size of journaling in a wide array of mental illnesses. Given the low risk of adverse effects, low resource requirement and emphasis on self-efficacy, primary care providers should consider this as an adjunct therapy to complement current evidence-based management.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935176/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy of journaling in the management of mental illness: a systematic review and meta-analysis.\",\"authors\":\"Monika Sohal, Pavneet Singh, Bhupinder Singh Dhillon, Harbir Singh Gill\",\"doi\":\"10.1136/fmch-2021-001154\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Journaling is a common non-pharmacological tool in the management of mental illness, however, no clear evidence-based guideline exists informing primary care providers on its use. 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引用次数: 0
摘要
日志是精神疾病管理中一种常见的非药物工具，然而，目前尚无明确的循证指南告知初级保健提供者如何使用日志。我们在此寻求提出这一综合，可能开始为未来的研究和最终的循证指南制定提供信息。从MEDLINE、EMBASE、PsycINFO检索的3797篇文献中，有20项同行评议的随机对照试验(31个结果)符合纳入标准。这些研究探讨了日记干预对创伤后应激障碍、其他焦虑症、抑郁症或上述综合疾病的影响。入选标准:同行评议的、关于日志对精神疾病影响的随机对照试验被纳入。信息来源MEDLINE, EMBASE和PsycINFO。结果数据具有高度异质性(对照组=I2 = 71.2%，干预组=I2 = 83.8%)，推荐强度为b级。另外还发现，在对照组(- 0.01,95% CI - 0.03至0.00)和干预组(- 0.06,95% CI - 0.09至- 0.03)之间存在显著的心理测量量表前后差异。这5%的组间差异表明，日志干预导致患者健康指标得分下降幅度更大。科恩对研究的效应大小分析表明，这种益处小到中等程度。结论需要进一步的研究来更好地定义预后。我们的综述表明，虽然有一些随机对照数据支持日志的好处，但高度的异质性和方法缺陷限制了我们明确得出关于日志对多种精神疾病的好处和效果大小的结论的能力。鉴于不良反应风险低，资源需求低，强调自我效能，初级保健提供者应考虑将其作为辅助治疗，以补充当前循证管理。
Efficacy of journaling in the management of mental illness: a systematic review and meta-analysis.
Objectives: Journaling is a common non-pharmacological tool in the management of mental illness, however, no clear evidence-based guideline exists informing primary care providers on its use. We seek here to present this synthesis that may begin to inform future research and eventual evidence-based guideline development.
Design: Of the 3797 articles retrieved from MEDLINE, EMBASE, PsycINFO, 20 peer-reviewed randomised control trials (31 outcomes) met inclusion criteria. These studies addressed the impact of a journaling intervention on PTSD, other anxiety disorders, depression or a combination of the aforementioned.
Eligibility criteria: Peer reviewed, randomised control trials on the impact of journaling on mental illness were included.
Information sources: MEDLINE, EMBASE and PsycINFO.
Results: The data are highly heterogeneous (control arm=I2 of 71.2%, intervention arm=I2 of 83.8%) combined with a B-level Strength of Recommendation Taxonomy recommendation. It was additionally found that there is a significant pre-post psychometric scale difference between control (-0.01, 95% CI -0.03 to 0.00) and intervention arms (-0.06, 95% CI -0.09 to -0.03). This 5% difference between groups indicates that a journaling intervention resulted in a greater reduction in scores on patient health measures. Cohen's d effect size analysis of studies suggests a small to moderate benefit.
Conclusion: Further studies are needed to better define the outcomes. Our review suggests that while there is some randomised control data to support the benefit of journaling, high degrees of heterogeneity and methodological flaws limit our ability to definitively draw conclusions about the benefit and effect size of journaling in a wide array of mental illnesses. Given the low risk of adverse effects, low resource requirement and emphasis on self-efficacy, primary care providers should consider this as an adjunct therapy to complement current evidence-based management.
期刊介绍：
Family Medicine and Community Health (FMCH) is a peer-reviewed, open-access journal focusing on the topics of family medicine, general practice and community health. FMCH strives to be a leading international journal that promotes ‘Health Care for All’ through disseminating novel knowledge and best practices in primary care, family medicine, and community health. FMCH publishes original research, review, methodology, commentary, reflection, and case-study from the lens of population health. FMCH’s Asian Focus section features reports of family medicine development in the Asia-pacific region. FMCH aims to be an exemplary forum for the timely communication of medical knowledge and skills with the goal of promoting improved health care through the practice of family and community-based medicine globally. FMCH aims to serve a diverse audience including researchers, educators, policymakers and leaders of family medicine and community health. We also aim to provide content relevant for researchers working on population health, epidemiology, public policy, disease control and management, preventative medicine and disease burden. FMCH does not impose any article processing charges (APC) or submission charges.
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