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研究生:裴美玲(釋妙尊)
研究生(外文):Mei-ling Pei
論文名稱:系統性文獻回顧與整合分析:催眠治療在「憂鬱症」與「憂鬱情緒」上之應用
論文名稱(外文):Systematic Review and Meta-analysis: The Application of Hypnotherapy in the Treatment of Depressive Disorder and Depressive Mood
指導教授:辜美安辜美安引用關係
指導教授(外文):Malcom Koo
學位類別:碩士
校院名稱:南華大學
系所名稱:自然醫學研究所
學門:醫藥衛生學門
學類:其他醫藥衛生學類
論文種類:學術論文
畢業學年度:95
語文別:中文
論文頁數:165
中文關鍵詞:憂鬱情緒憂鬱症催眠治療系統性文獻回顧整合分析心理治療
外文關鍵詞:hypnotherapymeta-analysissystematic reviewdepressive moodpsychotherapydepressive disorder
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  本研究主要探討催眠治療在憂鬱症與憂鬱情緒上之應用。由於「憂鬱症」與「憂鬱情緒」的定義不同,因此分別探討。催眠在憂鬱症之療效是採用系統性文獻回顧為研究工具,而催眠在憂鬱情緒之療效則以整合分析作為研究工具。分析的文獻來源有7個學術資料庫(PubMed; The Cochrane Collaboration Depression, Anxiety and Neurosis Review Group (CCDAN); Cochrane Library; Ebsco-Medline; PsiTri; PsycLit與Embase)及1個學術網站 (Google Scholar)。
 
  經過系統性文獻回顧有關催眠應用在憂鬱症病患的研究,符合納入條件的共有5篇(n=1167)文獻,族群是經過醫師診斷患有憂鬱症的病患(n=185)。結果發現這5篇研究中,沒有1篇是探討催眠治療憂鬱症之療效。另外,符合整合分析之納入條件的研究共有6篇(n=314),憂鬱情緒皆以「自我憂鬱量表」評定。本研究使用Comprehensive Meta-Analysis, Version 2之軟體計算效果量,結果發現催眠治療對憂鬱情緒有中度的療效(效果量=-0.566,p<0.001 )。
 
  在未來催眠治療之臨床研究,研究學者應該著重於更精密的實驗設計,以提高其研究品質,例如使用適當的對照組、雙盲、隨機抽樣及擴大族群,以減低實驗偏差及增加統計檢視力。研究報告若統一並根據隨機實驗報告所含的項目核對表(CONSORT checklist)來報導,則有助於未來的整合分析。

  本研究發現催眠治療對憂鬱情緒有中度的療效,但在憂鬱症上的療效卻未明確,故未來的研究可以進一步再探討催眠治療在憂鬱情緒與憂鬱症上之應用。
  The main objective of this study is to assess the effectiveness of hypnotherapy in the treatment of depressive disorder and depressive mood. As these two depressive conditions are different, separated analyses were conducted. A systematic review was performed to assess the effectiveness of hypnotherapy for depressive disorder and meta-analysis was used to provide a quantitative pooled estimate of the effect of hypnotherapy for depressive mood.
 
  To identify the literature, seven electronic databases (PubMed; The Cochrane Collaboration Depression, Anxiety and Neurosis Review Group (CCDAN); Cochrane Library; Ebsco-Medline; PsiTri; PsycLit; and Embase) and a website (Google Scholar) were searched. Five studies (n=1167) were identified in the systematic review of hypnotherapy for depressive disorder(n=185). None of the studies were able to clearly demonstrate the effectiveness of hypnotherapy in the treatment of depressive disorder. Six studies (n=314) that fulfilled the inclusion criteria were included in the meta-analysis of hypnotherapy in the treatment of depressive mood. A combined effect -0.566 (p<0.001) was estimated with the Comprehensive Meta-Analysis, Version 2 software.
 
  Future studies should pay attention to the study design and adopt the use of control group, double-blind, randomization, and adequate sample size to reduce experimental bias and enhance the statistical power. The report of the experiment should also be recorded accordingly to the Consort Checklist for the benefit of future meta-analysis to be carried out. Findings from this study showed that hypnotherapy has medium level effectiveness in the treatment of depressive mood while the effectiveness of hypnotherapy in the treatment of depressive disorder is still unclear. The application of the hypnotherapy in the treatment of mood disorders is still in its infancy stage but the findings are encouraging for further research.
中文摘要 i
英文摘要 iii
中英對照表 v
目次 x
表次 xiii
圖次 xiv
附錄 xv
  
第一章:緒論
第一節:研究背景 1
第二節:研究動機與目的 4
第三節:研究問題 12
  
第二章:文獻探討
第一節:催眠治療的定義 13
第二節:催眠治療的機轉 15
第三節:催眠的歷史 18
第四節:催眠治療的特徵 25
第五節:憂鬱症的定義與分類 31
第六節:憂鬱症的流行病學 38
第七節:憂鬱症之病因學及其應用 40
第八節:催眠治療與憂鬱症及憂鬱情緒的關聯性 45
第九節:系統性文獻回顧與整合分析 47
  
第三章:研究方法及步驟
第一節:研究方法 57
第二節:步驟流程圖 71
  
第四章:研究結果
第一節:原始研究樣本來源與描述 72
第二節:文獻回顧催眠與憂鬱症的關聯 73
第三節:整合分析催眠與憂鬱情緒的關聯 79
  
第五章:討論
第一節:研究的限制 96
第二節:整合分析之偏差 98
第三節:研究的品質及有效度 103
  
第六章:結論
第一節:結論 106
第二節:未來研究之建議 108
  
參考文獻 110
附錄 129
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1. 壓力與健康:整合分析與模式驗證之研究
2. 台灣健康信念模式研究之統合分析
3. 憂鬱症患者進行瑜珈運動介入促進生理心理健康之研究
4. 催眠療法對女性喪親者悲傷反應改變效果之研究
5. 癌症末期併憂鬱症病患之心理治療:存在─認知模式初步建構
6. 一個憂鬱症個案接受催眠治療生命轉變之探討
7. 更年期婦女骨質疏鬆症介入性措施之系統性回顧與統合分析
8. 系統性回顧及統合分析的研究方法釐清術後干擾素治療於肝癌病患的存活及幫助執行腹膜炎術後抗生素使用的臨床試驗
9. 探討紅血球生成素對慢性腎臟疾病患者之腎性貧血療效與不良事件之相關性
10. Part I: 統合分析比較再生膜導合併骨移植物引牙周再生對大臼齒二級牙根分岔治療效果之系統性回顧 Part II: 系統性回顧比較單純清創手術, 牙釉質基衍生物及再生膜導引手術對動物大臼齒三級牙根分岔之治療效果
11. 從組織學及二次翻瓣的角度探討動物和人類以牙周組織引導再生術治療骨內缺損的效果: 系統性回顧和整合分析方法
12. 牙科恐懼症認知行為療法之系統性回顧與整合分析
13. 單純性唇皰疹的治療介入-系統性綜論與統合分析
14. 手術衛教對心臟手術病人焦慮程度之影響:系統性文獻回顧暨後設分析
15. 心理師治療憂鬱症當事人之諮商經驗與治療因素研究
 
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