Objectives To evaluate the effectiveness of cognitive behavioral therapy (CBT) treating insomnia in patients with breast cancer. Methods Such databases as CENTRAL (April 2011), The Cochrane Library (2005 to November 2011), MEDLINE (1948 to April 2011), EMbase (Junuary 1966 to April 2011), CINAHL (Cumulative Index to Nursing and Allied Health Literature, 1982 to April 2011), CBM (1978 to 2011) and CNKI (1979 to 2011) were searched to collect the randomized controlled trials (RCTs) about CBT treating insomnia in patients with breast cancer. Literature screening, data extraction and methodological quality assessment of the included studies were conducted according to the inclusion and exclusion criteria. Then RevMan 5.0 software was used for meta-analysis. Results A total of 5 RCTs were included. The results of meta-analysis showed that, compared with the control group, the CBT group was higher in the score of subjective sleep efficiency; however, it was lower in the subjective sleep onset latency. There were no significant differences between the two groups in the sleep efficiency, total sleep time, sleep onset latency and wake time after sleep onset measured by hypnocinematograph. Conclusion Cognitive behavioral therapy may improve the subjective sleep efficiency and sleep quality, and shorten the sleep onset latency in patients with breast cancer. However, its effect of improving objective sleep quality is still unverifiable at present. It suggests the following measures should be taken for providing better evidences: increasing sample size, adopting blind methods, confirming allocation concealment, and using unified hypnocinematograph.
ObjectiveTo systematically review the efficacy of cognitive behavioral therapy (CBT) for improving mental health and social functions in patients with multiple sclerosis (MS). MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 4, 2016), CBM and CNKI from inception to May 2016, to collect randomized controlled trials (RCT) about CBT on mental health and social function in patients with MS. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 11 RCTs involving 1 102 patients were included. The results of meta-analysis showed that, the HADS scores (depression: MD=-1.28, 95%CI-2.07 to-0.48, P=0.002; anxiety: MD=-1.52, 95%CI-2.99 to-0.06, P=0.04), BDI scores (MD=-9.11, 95% CI-15.82 to-2.40, P=0.008), HRDS scores (MD=-7.23, 95% CI-13.65 to-0.82, P=0.03), Chalder scores (MD=-4.88, 95% CI-6.61 to-3.16, P < 0.000 01), MFIS scores (MD=-2.98, 95% CI-4.52 to-1.44, P=0.000 2) and GHQ-12 scores (MD=-3.61, 95%CI-5.20 to-2.02, P < 0.000 01) in the CBT group were lower than that in the control group. No significant difference was found in WSAS scores (MD=-1.98, 95%CI-4.88 to 0.93, P=0.18) between two groups. ConclusionCBT may be effective for improving the negative mental experience, fatigue and quality of life in MS. No evidence to support CBT has benefits in social functions. Due to the limited quantity and quality of the included studies, the above conclusion needs to be verified by more high quality studies.
ObjectivesTo systematically review the efficacy of telephone-delivered cognitive behavioral therapy (CBT) for insomnia. MethodsDatabases including PubMed, EMbase, PsycINFO, The Cochrane Library (Issue 7, 2015), CBM and CNKI were searched from inception to July 2015, to collect randomized controlled trials (RCT) about telephone-delivered CBT for insomnia. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.2 software was used to performing meta-analysis. ResultsFive RCTs involving 322 patients were included. The results of meta-analysis showed that:Compared with the waiting group, the sleep onset latency was shorter (MD=-30.31, 95% CI -40.41 to -20.22, P<0.00001), the waking after sleep onset was shorter (MD=-15.59, 95% CI -24.09 to -7.09, P=0.0003) and the sleep efficiency was higher (MD=11.02, 95% CI 7.87 to 14.18, P<0.00001) in the telephone-delivered CBT group, but there was no significant difference between the two groups in total sleep time (MD=13.45, 95% CI -37.01 to 63.92, P=0.60). ConclusionCurrent evidence shows, telephone-delivered CBT is effective for insomnia. Due to limited quantity and quality of the included studies, the above conclusion needs to be verified by more large-scale, high quality RCTs.
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. 1st, 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.
Objective To preliminarily assess the ameliorative effect of Mom’s Good Mood (MGM) on the prevalence of antenatal depression based on a pilot study, and to provide evidence for a scale-up study. Methods This study was conducted in Ma’anshan Maternal and Child Health Center as a pilot study of an implementation study conducted in China called the Perinatal Depression Screening and Management (PDSM) program. In 2019, 1 189 participants (gestational week ≤14+6 weeks) were included in the implementation group. Females were recruited in the first trimester and followed up in the second and third trimesters. At each time point, the participants’ depression status was screened by the Edinburgh postpartum depression scale (EPDS), and those who were screened as having depression were provided the MGM intervention. In 2020, 1 708 participants who underwent screening with the EPDS in either the first, second or third trimester at Ma’anshan Maternal and Child Health Center were included in the control group. Mann‒Whitney U test, Chi-square, and multivariate logistic regression analysis were used to compare the EPDS scores and depression prevalence between the control and implementation groups to assess the ameliorative effect of MGM (screening and intervention) on antenatal depression. Results In the first trimester, there were no statistically significant differences in EPDS scores or depression prevalence between the two groups (P>0.05). In the second and third trimesters, both the EPDS scores and depression prevalence of the implementation group were lower than those of the control group (P<0.05). After adjusting for confounders, logistic regression analysis showed that the risks of depression in the implementation group in both the second and third trimesters were lower than those in the control group (ORsecond trimester=0.55, 95%CI 0.37 to 0.81, P=0.003; ORthird trimester=0.51, 95%CI 0.35 to 0.74, P<0.001). Conclusion Implementation of the MGM based on the primary care system can effectively reduce the prevalence of antenatal depression, providing evidence for further scale up.