梅尼埃病患者焦虑的频率和严重程度：系统综述和荟萃分析。

文献信息

中文摘要

背景： 梅尼埃病（MD）是一种慢性、进行性的内耳疾病，目前无法治愈。焦虑是这些患者眩晕发作的已知加重因素；然而，其在该人群中的确切频率和水平仍未明确。
目的： 本研究旨在综合有关MD患者焦虑频率和水平的现有证据。
设计： 根据PRISMA和MOOSE指南报告的系统综述和荟萃分析。
参与者： 纳入截至2023年5月发表的、报告MD患者焦虑频率和/或严重程度的观察性研究，不限国家或发表时间。
主要结局指标： 系统检索PubMed、Embase、Scopus、LILACS、Web of Science和PsycINFO以识别相关文章。两名独立评审员筛选研究、提取数据并评估纳入研究的方法学质量。由于纳入研究使用了不同的焦虑评估工具，探索性荟萃分析仅限于使用贝克焦虑量表（BAI）的研究，因为该量表提供了关于焦虑严重程度分类和平均评分的可比数据。
结果： 共纳入8项研究，涉及283例患者。其中3项研究纳入基于BAI的荟萃分析。根据BAI量表评估，中度至重度焦虑的合并患病率为68%（95% CI：43-75%；I2 = 56.3%；2项研究；n = 99）。BAI评分的合并均值为23.26分（95% CI：19.31-27.21；I2 = 53.8%，2项研究；n = 88），根据BAI截断值，该分值属于中度焦虑范围。大多数研究具有较好的方法学质量。
结论： 基于有限的BAI证据，中度至重度焦虑似乎在MD患者中较为常见，且BAI评分的合并均值提示焦虑严重程度为中度。
相关性： 主要的MD管理指南尚未涉及这一问题。心理和/或药物焦虑治疗应被视为其管理的重要组成部分。记录号：CRD42023431494（PROSPERO）。

英文摘要

BACKGROUND: Ménière's disease (MD) is a chronic, progressive disorder of the inner ear, which is currently incurable. Anxiety is a known exacerbating factor for vertigo episodes in these patients; however, its precise frequency and levels in this population remain undefined.
OBJECTIVE: The purpose of this study is to synthesize the available evidence related to the frequency and levels of anxiety in patients with MD.
DESIGN: A systematic review and meta-analysis reported according to PRISMA and MOOSE guidelines.
PARTICIPANTS: Observational studies, published until May 2023, reporting the frequency and/or severity of anxiety in patients with MD were included, with no restrictions by country or publication date.
MAIN OUTCOME MEASURES: PubMed, Embase, Scopus, LILACS, Web of Science, and PsycINFO were systematically searched to identify relevant articles. Two independent reviewers selected studies, extracted data, and assessed the methodological quality of the included studies. Because the included studies used different anxiety instruments, exploratory meta-analyses were restricted to studies using the Beck Anxiety Inventory (BAI), which provided comparable data on anxiety severity categories and mean scores.
RESULTS: Eight studies involving 283 patients were selected. Three contributed to the BAI-based meta-analyses. The pooled prevalence of moderate-to-severe anxiety, as assessed by the BAI scale, was 68% (95% CI: 43-75%; I2 = 56.3%; 2 studies; n = 99). The pooled mean BAI score was 23.26 points (95% CI: 19.31-27.21; I2 = 53.8%, 2 studies; n = 88), which falls within the moderate anxiety range according to BAI cut-off points. Most studies had good methodological quality.
CONCLUSIONS: Based on the limited BAI-based evidence available, moderate-to-severe anxiety appears to be frequent among patients with MD, and the pooled mean BAI score suggests moderate anxiety severity.
RELEVANCE: Major MD management guidelines have not addressed this issue. Psychological and/or pharmacological anxiety treatment should be considered an essential component of its management. Record: CRD42023431494 (PROSPERO).