目的通过meta分析评价元认知疗法(MCT)对强迫症(OCD)的干预效果。方法在PubMed、Web of Science、ScienceDirect和PsycInfo数据库中检索相关文献,检索时间范围设定为2010年1月1日至2025年3月1日。纳入MCT治疗OCD的随机对照试验进行meta...目的通过meta分析评价元认知疗法(MCT)对强迫症(OCD)的干预效果。方法在PubMed、Web of Science、ScienceDirect和PsycInfo数据库中检索相关文献,检索时间范围设定为2010年1月1日至2025年3月1日。纳入MCT治疗OCD的随机对照试验进行meta分析,由2名研究者独立进行文献筛选及数据提取工作。根据Cochrane评价手册5.0.1版对纳入的文献进行质量评价,使用RevMan 5.3软件进行数据分析。采用耶鲁-布朗强迫量表评估强迫症状。结果检出2171篇文献,其中13篇符合纳入条件,共1111例患者。结果表明,MCT对OCD患者的强迫症状的改善与传统方法[暴露反应预防疗法(ERP)]相近,差异无统计学意义(均数差=0.04,95%CI-1.28~1.36,P=0.95)。结论MCT对改善OCD核心症状的疗效与ERP相当,且因其结构化、短程化(8~12周)的特点可能降低治疗脱落率。MCT为OCD治疗提供了有价值的ERP替代方案,尤其适合资源有限的医疗场景,但仍需更多高质量、多样化的临床研究进一步验证其优势。展开更多
Objective Previous studies link lower body mass index(BMI)with increased obsessive-compulsive disorder(OCD)risk,yet other body mass indicators may be more etioloically relevant.We dissected the causal association betw...Objective Previous studies link lower body mass index(BMI)with increased obsessive-compulsive disorder(OCD)risk,yet other body mass indicators may be more etioloically relevant.We dissected the causal association between body fat mass(FM)and OCD.Methods Summary statistics from genome-wide association studies of European ancestry were utilized to conduct two-sample Mendelian randomization analysis.Heterogeneity,horizontal pleiotropy,and sensitivity analyses were performed to assess the robustness.Results The inverse variance weighting method demonstrated that a genetically predicted decrease in FM was causally associated with an increased OCD risk[odds ratio(OR)=0.680,95%confidence interval(CI):0.528–0.875,P=0.003].Similar estimates were obtained using the weighted median approach(OR=0.633,95%CI:0.438–0.915,P=0.015).Each standard deviation increases in genetically predicted body fat percentage corresponded to a reduced OCD risk(OR=0.638,95%CI:0.455–0.896,P=0.009).The sensitivity analysis confirmed the robustness of these findings with no outlier instrument variables identified.Conclusion The negative causal association between FM and the risk of OCD suggests that the prevention or treatment of mental disorders should include not only the control of BMI but also fat distribution and body composition.展开更多
文摘目的通过meta分析评价元认知疗法(MCT)对强迫症(OCD)的干预效果。方法在PubMed、Web of Science、ScienceDirect和PsycInfo数据库中检索相关文献,检索时间范围设定为2010年1月1日至2025年3月1日。纳入MCT治疗OCD的随机对照试验进行meta分析,由2名研究者独立进行文献筛选及数据提取工作。根据Cochrane评价手册5.0.1版对纳入的文献进行质量评价,使用RevMan 5.3软件进行数据分析。采用耶鲁-布朗强迫量表评估强迫症状。结果检出2171篇文献,其中13篇符合纳入条件,共1111例患者。结果表明,MCT对OCD患者的强迫症状的改善与传统方法[暴露反应预防疗法(ERP)]相近,差异无统计学意义(均数差=0.04,95%CI-1.28~1.36,P=0.95)。结论MCT对改善OCD核心症状的疗效与ERP相当,且因其结构化、短程化(8~12周)的特点可能降低治疗脱落率。MCT为OCD治疗提供了有价值的ERP替代方案,尤其适合资源有限的医疗场景,但仍需更多高质量、多样化的临床研究进一步验证其优势。
基金supported by the Yanzhao Gold Talent Project of Hebei Province(NO.HJZD202506)。
文摘Objective Previous studies link lower body mass index(BMI)with increased obsessive-compulsive disorder(OCD)risk,yet other body mass indicators may be more etioloically relevant.We dissected the causal association between body fat mass(FM)and OCD.Methods Summary statistics from genome-wide association studies of European ancestry were utilized to conduct two-sample Mendelian randomization analysis.Heterogeneity,horizontal pleiotropy,and sensitivity analyses were performed to assess the robustness.Results The inverse variance weighting method demonstrated that a genetically predicted decrease in FM was causally associated with an increased OCD risk[odds ratio(OR)=0.680,95%confidence interval(CI):0.528–0.875,P=0.003].Similar estimates were obtained using the weighted median approach(OR=0.633,95%CI:0.438–0.915,P=0.015).Each standard deviation increases in genetically predicted body fat percentage corresponded to a reduced OCD risk(OR=0.638,95%CI:0.455–0.896,P=0.009).The sensitivity analysis confirmed the robustness of these findings with no outlier instrument variables identified.Conclusion The negative causal association between FM and the risk of OCD suggests that the prevention or treatment of mental disorders should include not only the control of BMI but also fat distribution and body composition.
