JCRP：家庭为基础的二级预防对抑郁的疗效

　　近日发表于《J Cardiopulm Rehabil Prev.》的一项研究为以家庭为基础二级干预降低焦虑程度的有效性提供了证据。由于试验数量有限和数据高度异质，关于以家庭为基础的项目降低冠心病(CAD)患者焦虑的利益，需要更多的研究提供明确的答案。

　　焦虑症在CAD患者中较为普遍。尽管以家庭为基础的CAD预防干预有益于提高生活质量和减少动脉粥样硬化危险因素，但是以家庭为基础的项目对于减少焦虑症的效果仍然不明确。

　　该研究对随机实验进行了系统综述和荟萃分析。随机试验均来自于18个数据库，发表日期在2009年12月份之前，对以家庭为基础的干预减少焦虑症的效果进行了评估。分析基于不同处理组之间的标准均数差。

　　该研究共综述8项包含干预方法以及对焦虑症标准差的实验。实验的整体质量为低等到中等。结果表明，与常规护理以及以中心为基础的心脏康复相比较，以家庭为基础的干预对于减少焦虑具有小但显著的效果（总效应值：-0.13; 95% CI: -0.20 to -0.06; P < .001; I = 66%）。 

与抑郁相关的拓展阅读：

• Biol Psychiat.：实验药物有望‘在数分钟内’帮助治疗抑郁
• 生活方式干预延缓抑郁症状进展
• Pain Medicine：初级护理患者的疼痛、慢性疾病、抑郁症与IL-6
• Lupus：血清肿瘤坏死因子-α水平与系统性红斑狼疮患者的生活质量和抑郁症状相关
• JAMA Psychiatry：DSM-IV中关于重性抑郁诊断标准的多个遗传因素证据 更多信息请点击：有关抑郁更多资讯

Home-based secondary prevention programs for patients with coronary artery disease: a meta-analysis of effects on anxiety.
PURPOSE
Anxiety is common among patients with coronary artery disease (CAD). Despite the benefits of home-based CAD prevention interventions on quality of life and atherosclerotic risk factors, the efficacy of home-based programs in reducing patient anxiety is unknown.
METHODS
We performed a systematic review and meta-analysis of all randomized trials that examined the effects of home-based interventions on anxiety reduction in patients with CAD published in 18 databases until December 2009. Analyses were based on changes in the standardized mean difference between treatment groups.
RESULTS
Eight trials containing intervention means and standard deviations on anxiety were reviewed. Overall quality of the trials was low to moderate. Compared with usual care or center-based cardiac rehabilitation, home-based interventions had a small but significant effect in reducing anxiety (total effect size: -0.13; 95% CI: -0.20 to -0.06; P < .001; I = 66%).
CONCLUSIONS
This meta-analysis provides evidence that home-based secondary prevention programs are effective in reducing anxiety level in CAD patients. However, because of the limited number of trials available and high degrees of heterogeneity in the data, further research needs to be done to provide a definitive answer on the benefits of home-based programs on anxiety management in CAD patients.