抑郁情绪是老年人常见的情绪问题，尤其是在因躯体疾病住院的老年人群中，抑郁情绪问题的流行率更高。在该领域广为接受的观点是，抑郁与躯体疾病存在相互作用：一方面，抑郁情绪经常恶化躯体症状，降低治疗依从性，导致更高的发病率和功能障碍；另一方面，躯体疾病容易引发抑郁反应。因此，针对抑郁的心理干预是否能有效降低该群体的抑郁症状，同时促进其躯体疾病康复呢？
最近几十年，国内采用源于西方的心理治疗方法（认知行为疗法、支持疗法等）就这一群体进行了大量的心理干预的实证研究，为解答这一问题积累了丰富的资料。但由于研究成果发表在本土杂志上，这些研究不为国外学者所熟知。为了检验在中国文化背景下，西方的心理治疗方法是否对该群体有效，中国科学院心理健康重点实验室李娟研究员课题组系统检索了1964-2008年《中国知网》数据库上发表的躯体疾病伴发抑郁症状的住院老年人的心理干预的实证研究。通过对最终纳入的12篇合格文献进行元分析，她们发现，与常规护理相比，心理干预能显著地降低该群体的抑郁水平，效果量达到了较高水平。此外，心理干预不仅能有效治愈患者抑郁问题，而且有助于患者躯体疾病的康复：接受心理干预的患者的躯体疾病治疗治愈率是常规护理组的1.52倍。
而在临床上，50%的因躯体疾病住院的老年人的抑郁症状并没有得到有效的识别和治疗，同时由于抗抑郁药物的副作用，59.62%的老年人更愿意接受心理干预。鉴于该研究证实心理干预的有效性，因此在医疗场景中，应更加重视对患躯体疾病老人的抑郁症状开展心理干预。
本研究受到科技部科技支撑计划（2009BAI77B03）、国家自然科学基金(30770725, 31070916)以及中国科学院知识创新工程重要方向项目（KSCX2-YW-R-256）支持。
该论文已被《BMC精神病学》（BMC Psychiatry）接受：Dai, B., Li, J.*, Cuijpers, P. (2011). Psychological treatment of depressive symptoms in Chinese elderly inpatients with significant medical comorbidity: A meta-analysis. BMC Psychiatry, In press. doi:10.1186/1471-244X-11-92.
BMC：心理干预能显著治疗老年人抑郁
生物探索推荐英文论文摘要：
Psychological treatment of depressive symptoms in Chinese elderly inpatients with significant medical comorbidity: A meta-analysis
Abstract
Background
As it is uncertain whether psychological treatments for depressive symptoms are effective in elderly inpatients with significant medical comorbidity, we aimed to assess the treatment effectiveness not only on depressive symptoms but also on somatic symptoms in these inpatients.
Methods
We performed a meta-analysis of randomized controlled studies assessing the effects of psychological treatments in Chinese older inpatients with significant medical comorbidity based upon extensive searches of the most comprehensive computerized Chinese academic database.
Results
The overall effect size for depressive symptoms of twelve studies which compared psychological treatments with a care-as-usual control group was d = 0.80 (95% Confidence Intervals (CI) = 0.60-0.99; p < 0.001). The relative risk of psychological intervention of being effective or not, compared to control condition, was 1.52 (95% CI = 1.25-1.85; p < 0.001).
Conclusions
We conclude that psychological treatments of depressive symptoms are effective for Chinese elderly inpatients with significant medical comorbidity which should receive more attention in medical settings.
