Influence of cognitive behavioral therapy on depression, anxiety and quality of life in patients with maintenance hemodialysis (MHD): a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

LI Hong ¹ , WANG Lang ¹ , ZHAO Li ¹ , XIE Lantian ² , CHEN Huageng ¹ ,  PANG Xiaoli ³

1. Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, P.R.China;
2. Tianjin Huanhu Hospital, Tianjin 300350, P.R.China;
3. School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, P.R.China;

Corresponding author：

PANG Xiaoli, Email: 403033115@qq.com

Keywords：

Cognitive behavioral therapy; Renal dialysis; Depression; Anxiety; Quality of life; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.201611073

Video：

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Objective To systematically evaluate the effects of cognitive behavioral therapy (CBT) on improving depression, anxiety and quality of life in patients with maintenance hemodialysis (MHD). Methods We searched PubMed, EMbase, CENTRAL (Issue 8, 2016), Web of Science, CINAHL, PsycoINFO, CBM, CNKI and WanFang Data from inception to Sep. 1^st, 2016, to collect randomized controlled trials (RCTs) which studied the effects of CBT on improving depression, anxiety and quality of life in patients with MHD. Literature screening, data extraction, and the risk of bias assessment of all eligible studies were conducted by two reviewers independently. Then, meta-analysis was conducted using RevMan 5.3 software. Results A total of 14 RCTs involving 1 492 patients were included. The results of meta-analysis showed that CBT could significantly improve the depression (SMD=–0.85, 95%CI –0.96 to –0.74,P<0.000 01), anxiety (SMD=–1.16, 95%CI –1.37 to –0.94,P<0.000 01), and quality of life (SMD=0.88, 95%CI 0.21 to 1.56,P=0.010) of MHD patients after 2 months' intervention; however, these effects were not been found within 2 months' intervention (allP values>0.05). Conclusion CBT is efficacious in improving MHD patients' depression, anxiety and quality of life after 2 months' intervention, while these effects within 2 months are still not certain. Because of the limitation of quantity and quality of included studies, more high-quality studies are needed to confirm the above conclusion.

Citation： LIHong, WANGLang, ZHAOLi, XIELantian, CHENHuageng, PANGXiaoli. Influence of cognitive behavioral therapy on depression, anxiety and quality of life in patients with maintenance hemodialysis (MHD): a systematic review. Chinese Journal of Evidence-Based Medicine, 2017, 17(2): 152-161. doi: 10.7507/1672-2531.201611073 Copy

1.	Bayoumi M, Al Harbi A, Al Suwaida A,et al. Predictors of quality of life in hemodialysis patients. Saudi J Kidney Dis Transpl, 2013, 24(2): 254-259.
2.	Chung YC, Yeh ML, Liu YM. Effects of Intradialytic Exercise on the Physical Function, Depression, and Quality of Life for Hemodialysis Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Clin Nurs, 2016, DOI: 10.1111/jocn.13514.
3.	Turkistani I, Nuqali A, Badawi M,et al. The prevalence of anxiety and depression among end-stage renal disease patients on hemodialysis in Saudi Arabia. Ren Fail, 2014, 36(10): 1510-1515.
4.	Parvan K, Lakdizaji S, Roshangar F,et al. Quality of sleep and its relationship to quality of life in hemodialysis patients. J Caring Sci, 2013, 2(4): 295-304.
5.	Vasilopoulou C, Bourtsi E, Giaple S,et al. The Impact of Anxiety and Depression on the Quality of Life of Hemodialysis Patients. Glob J Health Sci, 2016, 8(1): 45-55.
6.	Ng HJ, Tan WJ, Mooppil N,et al. Prevalence and patterns of depression and anxiety in hemodialysis patients: a 12-month prospective study on incident and prevalent populations. Br J Health Psychol, 2015, 20(2): 374-395.
7.	Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin Neurosci, 2015, 17(3): 337-346.
8.	American Psychiatric Association: Practice Guideline for the Treatment of Patients with Major Depressive Disorder.3rd Ed, Washington, DC: American Psychiatric Association, 2010.
9.	周桂霞, 张金艳, 李国荣. 团体认知行为干预对维持性血液透析患者抑郁的研究. 中国健康心理学杂志, 2012, 20(11): 1698-1699.
10.	刘君君. 探讨认知行为干预对维持血液透析患者生活质量的影响. 中西医结合护理(中英文), 2016, 2(2): 79-81.
11.	Kim MA, Kim J, Kim EJ. Effects of rational emotive behavior therapy for senior nursing students on coping strategies and self-efficacy. Nurse Educ Today, 2015, 35(3): 456-460.
12.	Lerma A, Perez-Grovas H, Bermudez L,et al. Brief cognitive behavioural Intervention for depression and anxiety symptoms improves quality of life in chronic haemodialysis patients. Psychol Psychother, 2016, DOI: 10.1111/papt.12098.
13.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. London: The Cochrane Collaboration, 2011.
14.	Chen HY, Cheng IC, Pan YJ,et al. Cognitive-behavioral therapy for sleep disturbance decreases inflammatory cytokines and oxidative stress in hemodialysis patients. Kidney Int, 2011, 80(4): 415-422.
15.	陈媛. 心理认知行为干预对尿毒症血液透析患者抑郁、焦虑的影响. 国际护理学杂志, 2016, 35(6): 812-814.
16.	Cukor D, Ver HN, Asher DR,et al. Psychosocial intervention improves depression, quality of life, and fluid adherence in hemodialysis. J Am Soc Nephrol, 2014, 25(1): 196-206.
17.	Duarte PS, Miyazaki MC, Blay SL,et al. Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis patients. Kidney Int, 2009, 76(4): 414-421.
18.	Hou Y, Hu P, Liang Y,et al. Effects of cognitive behavioral therapy on insomnia of maintenance hemodialysis patients. Cell Biochem Biophys, 2014, 69(3): 531-537.
19.	李俊, 霍桢, 俞翔, 等. 认知行为团体治疗对维持性血液透析患者心理干预的疗效. 陕西医学杂志, 2013, 42(5): 553-555.
20.	刘凤兰, 曹建荣. 认知行为干预对维持性血液透析患者生活质量的作用探讨. 中国当代医学, 2008, 7(8): 67-68.
21.	刘社娟, 张运生. 团体认知干预对维持性血液透析患者焦虑抑郁情绪、血红蛋白、白蛋白及肌酐水平的影响. 河南大学学报(医学版), 2011, 30(2): 110-112.
22.	潘妍君. 团体认知行为护理干预对 MHD 患者焦虑抑郁水平、营养状态及生存质量的影响. 牡丹江医学院学报, 2016, 37(2): 133-136.
23.	吴雪, 冯美丽, 娄凤兰, 等. 认知行为干预对维持性血液透析患者生活质量的影响. 中华护理杂志, 2006, 41(8): 715-717.
24.	仲君萍. 认知行为干预对维持性血液透析患者生活质量的影响研究. 湖北民族学院学报(医学版), 2011, 28(3): 53-55, 58.
25.	周桂霞, 刘建军, 唱丽荣. 团体认知行为干预对维持性血液透析患者液体摄入依从性的影响. 齐鲁护理杂志, 2011, 17(34): 51-52.
26.	周学兰. 认知行为干预在尿毒症血液透析患者护理中的临床意义. 职业与健康, 2013, 29(21): 2891-2893, 2896.
27.	Thoma N, Pilecki B, Mckay D. Contemporary Cognitive Behavior Therapy: A Review of Theory, History, and Evidence. Psychodyn Psychiatry, 2015, 43(3): 423-461.
28.	Nieuwenhuijsen K, Verbeek JH, de Boer AG,et al. Irrational Beliefs in Employees with an Adjustment, a Depressive, or an Anxiety Disorder: a Prospective Cohort Study. J Ration Emot Cogn Behav Ther, 2010, 28(2): 57-72.
29.	Turner M J. Rational Emotive Behavior Therapy (REBT), Irrational and Rational Beliefs, and the Mental Health of Athletes. Front Psychol, 2016, 7: 1423.
30.	Otte C. Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin Neurosci, 2011, 13(4): 413-421.
31.	Okumura Y, Ichikura K. Efficacy and acceptability of group cognitive behavioral therapy for depression: a systematic review and meta-analysis. J Affect Disord, 2014, 164(6): 155-164.
32.	Donia AF, Zaki NF, Elassy M,et al. Study of depression and quality of life among hemodialysis patients: an Egyptian experience. Int Urol Nephrol, 2015, 47(11): 1855-1862.
33.	田君叶, 孙文秀, 刘钟缘, 等. 血液透析初期患者的内心体验. 中国护理管理, 2015, 15(7): 804-807.
34.	Visla A, Fluckiger C, Grosse HM,et al. Irrational Beliefs and Psychological Distress: A Meta-Analysis. Psychother Psychosom, 2016, 85(1): 8-15.
35.	张嘉祺, 张鸿悦, 唐芯, 等. 认知行为疗法改善多发性硬化患者心理状态及社会功能效果的 Meta 分析. 中国循证医学杂志, 2016, 16(8): 953-961.
36.	Hofmann SG, Asnaani A, Vonk IJ,et al. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res, 2012, 36(5): 427-440.
37.	Koffel EA, Koffel JB, Gehrman PR. A meta-analysis of group cognitive behavioral therapy for insomnia. Sleep Med Rev, 2015, 19: 6-16.
38.	Trbojevic-Stankovic J, Stojimirovic B, Bukumiric Z,et al. Depression and quality of sleep in maintenance hemodialysis patients. Srp Arh Celok Lek, 2014, 142(7-8): 437-443.
39.	D'Onofrio G, Simeoni M, Rizza P,et al. Quality of life, clinical outcome, personality and coping in chronic hemodialysis patients. Ren Fail, 2016, 74(23): 1-9.
40.	Oliveira AP, Schmidt DB, Amatneeks TM,et al. Quality of life in hemodialysis patients and the relationship with mortality, hospitalizations and poor treatment adherence. J Bras Nefrol, 2016, 38(4): 411-420.
41.	Al-Ali FS, Bieber BA, Pisoni RL,et al. Nutritional status and outcomes in hemodialysis patients from the Gulf Cooperation Council countries enrolled in the dialysis outcome and practice patterns study phase 5 (2012-2015). Saudi J Kidney Dis Transpl, 2016, 27(Sup): 31-41.

1. Bayoumi M, Al Harbi A, Al Suwaida A,et al. Predictors of quality of life in hemodialysis patients. Saudi J Kidney Dis Transpl, 2013, 24(2): 254-259.
2. Chung YC, Yeh ML, Liu YM. Effects of Intradialytic Exercise on the Physical Function, Depression, and Quality of Life for Hemodialysis Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Clin Nurs, 2016, DOI: 10.1111/jocn.13514.
3. Turkistani I, Nuqali A, Badawi M,et al. The prevalence of anxiety and depression among end-stage renal disease patients on hemodialysis in Saudi Arabia. Ren Fail, 2014, 36(10): 1510-1515.
4. Parvan K, Lakdizaji S, Roshangar F,et al. Quality of sleep and its relationship to quality of life in hemodialysis patients. J Caring Sci, 2013, 2(4): 295-304.
5. Vasilopoulou C, Bourtsi E, Giaple S,et al. The Impact of Anxiety and Depression on the Quality of Life of Hemodialysis Patients. Glob J Health Sci, 2016, 8(1): 45-55.
6. Ng HJ, Tan WJ, Mooppil N,et al. Prevalence and patterns of depression and anxiety in hemodialysis patients: a 12-month prospective study on incident and prevalent populations. Br J Health Psychol, 2015, 20(2): 374-395.
7. Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin Neurosci, 2015, 17(3): 337-346.
8. American Psychiatric Association: Practice Guideline for the Treatment of Patients with Major Depressive Disorder.3rd Ed, Washington, DC: American Psychiatric Association, 2010.
9. 周桂霞, 张金艳, 李国荣. 团体认知行为干预对维持性血液透析患者抑郁的研究. 中国健康心理学杂志, 2012, 20(11): 1698-1699.
10. 刘君君. 探讨认知行为干预对维持血液透析患者生活质量的影响. 中西医结合护理(中英文), 2016, 2(2): 79-81.
11. Kim MA, Kim J, Kim EJ. Effects of rational emotive behavior therapy for senior nursing students on coping strategies and self-efficacy. Nurse Educ Today, 2015, 35(3): 456-460.
12. Lerma A, Perez-Grovas H, Bermudez L,et al. Brief cognitive behavioural Intervention for depression and anxiety symptoms improves quality of life in chronic haemodialysis patients. Psychol Psychother, 2016, DOI: 10.1111/papt.12098.
13. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. London: The Cochrane Collaboration, 2011.
14. Chen HY, Cheng IC, Pan YJ,et al. Cognitive-behavioral therapy for sleep disturbance decreases inflammatory cytokines and oxidative stress in hemodialysis patients. Kidney Int, 2011, 80(4): 415-422.
15. 陈媛. 心理认知行为干预对尿毒症血液透析患者抑郁、焦虑的影响. 国际护理学杂志, 2016, 35(6): 812-814.
16. Cukor D, Ver HN, Asher DR,et al. Psychosocial intervention improves depression, quality of life, and fluid adherence in hemodialysis. J Am Soc Nephrol, 2014, 25(1): 196-206.
17. Duarte PS, Miyazaki MC, Blay SL,et al. Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis patients. Kidney Int, 2009, 76(4): 414-421.
18. Hou Y, Hu P, Liang Y,et al. Effects of cognitive behavioral therapy on insomnia of maintenance hemodialysis patients. Cell Biochem Biophys, 2014, 69(3): 531-537.
19. 李俊, 霍桢, 俞翔, 等. 认知行为团体治疗对维持性血液透析患者心理干预的疗效. 陕西医学杂志, 2013, 42(5): 553-555.
20. 刘凤兰, 曹建荣. 认知行为干预对维持性血液透析患者生活质量的作用探讨. 中国当代医学, 2008, 7(8): 67-68.
21. 刘社娟, 张运生. 团体认知干预对维持性血液透析患者焦虑抑郁情绪、血红蛋白、白蛋白及肌酐水平的影响. 河南大学学报(医学版), 2011, 30(2): 110-112.
22. 潘妍君. 团体认知行为护理干预对 MHD 患者焦虑抑郁水平、营养状态及生存质量的影响. 牡丹江医学院学报, 2016, 37(2): 133-136.
23. 吴雪, 冯美丽, 娄凤兰, 等. 认知行为干预对维持性血液透析患者生活质量的影响. 中华护理杂志, 2006, 41(8): 715-717.
24. 仲君萍. 认知行为干预对维持性血液透析患者生活质量的影响研究. 湖北民族学院学报(医学版), 2011, 28(3): 53-55, 58.
25. 周桂霞, 刘建军, 唱丽荣. 团体认知行为干预对维持性血液透析患者液体摄入依从性的影响. 齐鲁护理杂志, 2011, 17(34): 51-52.
26. 周学兰. 认知行为干预在尿毒症血液透析患者护理中的临床意义. 职业与健康, 2013, 29(21): 2891-2893, 2896.
27. Thoma N, Pilecki B, Mckay D. Contemporary Cognitive Behavior Therapy: A Review of Theory, History, and Evidence. Psychodyn Psychiatry, 2015, 43(3): 423-461.
28. Nieuwenhuijsen K, Verbeek JH, de Boer AG,et al. Irrational Beliefs in Employees with an Adjustment, a Depressive, or an Anxiety Disorder: a Prospective Cohort Study. J Ration Emot Cogn Behav Ther, 2010, 28(2): 57-72.
29. Turner M J. Rational Emotive Behavior Therapy (REBT), Irrational and Rational Beliefs, and the Mental Health of Athletes. Front Psychol, 2016, 7: 1423.
30. Otte C. Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin Neurosci, 2011, 13(4): 413-421.
31. Okumura Y, Ichikura K. Efficacy and acceptability of group cognitive behavioral therapy for depression: a systematic review and meta-analysis. J Affect Disord, 2014, 164(6): 155-164.
32. Donia AF, Zaki NF, Elassy M,et al. Study of depression and quality of life among hemodialysis patients: an Egyptian experience. Int Urol Nephrol, 2015, 47(11): 1855-1862.
33. 田君叶, 孙文秀, 刘钟缘, 等. 血液透析初期患者的内心体验. 中国护理管理, 2015, 15(7): 804-807.
34. Visla A, Fluckiger C, Grosse HM,et al. Irrational Beliefs and Psychological Distress: A Meta-Analysis. Psychother Psychosom, 2016, 85(1): 8-15.
35. 张嘉祺, 张鸿悦, 唐芯, 等. 认知行为疗法改善多发性硬化患者心理状态及社会功能效果的 Meta 分析. 中国循证医学杂志, 2016, 16(8): 953-961.
36. Hofmann SG, Asnaani A, Vonk IJ,et al. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res, 2012, 36(5): 427-440.
37. Koffel EA, Koffel JB, Gehrman PR. A meta-analysis of group cognitive behavioral therapy for insomnia. Sleep Med Rev, 2015, 19: 6-16.
38. Trbojevic-Stankovic J, Stojimirovic B, Bukumiric Z,et al. Depression and quality of sleep in maintenance hemodialysis patients. Srp Arh Celok Lek, 2014, 142(7-8): 437-443.
39. D'Onofrio G, Simeoni M, Rizza P,et al. Quality of life, clinical outcome, personality and coping in chronic hemodialysis patients. Ren Fail, 2016, 74(23): 1-9.
40. Oliveira AP, Schmidt DB, Amatneeks TM,et al. Quality of life in hemodialysis patients and the relationship with mortality, hospitalizations and poor treatment adherence. J Bras Nefrol, 2016, 38(4): 411-420.
41. Al-Ali FS, Bieber BA, Pisoni RL,et al. Nutritional status and outcomes in hemodialysis patients from the Gulf Cooperation Council countries enrolled in the dialysis outcome and practice patterns study phase 5 (2012-2015). Saudi J Kidney Dis Transpl, 2016, 27(Sup): 31-41.

Chinese Journal of Evidence-Based Medicine

Influence of cognitive behavioral therapy on depression, anxiety and quality of life in patients with maintenance hemodialysis (MHD): a systematic review

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