Biofeedback e sua aplicabilidade nas psicopatologias - uma revisão sistemática

Abstract

Among the proposed treatments for mental disorders, biofeedback therapy is one of many approaches. Such therapy aims to assist the individual to take responsibility for their well-being, encompassing responsibility for the cognitive, emotional, and behavioral changes necessary to effect healthy physiological changes. In this systematic review we aimed to investigate in which psychopathologies biofeedback and neurofeedback have been used, as well as to verify the existence of evidence of its effectiveness in these psychopathologies. A search was carried out in five electronic databases (PubMed / Medline, SCOPUS, Web of Science, PsycInfo and Scielo), using boolean combinations of the term "biofeedback" (AND) with terms derived from the International Classification of Diseases for Mortality and Morbidity Statistics- 10 (ICD-10). Next, new combinations were employed by adding the term "intervention" to the combinations described. A total of 14,350 studies were included in the data set. We analyzed original studies, whose objective was to investigate the efficacy of biofeedback in the treatment of psychopathologies, written in Portuguese and / or English and published between the years of 2012-2017. After completing several selection steps, 49 studies were included in the final data set and analyzed according to: sample description (pathology; age; type of biofeedback), design (Randomization; Control, Blinding; Statistic for sample size, Follow-up, size of effect, intention-to-treat, Multicenter, Pilot) and protocol (number of training sessions, number of intervention sessions, duration of intervention session, frequency of sessions and duration of research). Biofeedback and neurofeedback were found mostly used in attention deficit hyperactivity disorder, major depressive disorder, autism spectrum disorder, alcohol dependence, binge eating, and stress. Most (51.02%) of the studies analyzed did not use effect size measures and only one fifth (20.42%) did indeed find any effect on interventions with biofeedback or neurofeedback. All 13 studies that found some bio or neurofeedback effect contained important methodological flaws. Considering all the methodological aspects and biases of each one of the failures, it was verified that none of the studies was able to contemplate all the methodological requirements so that the effectiveness of the treatment with the biofeedback and the neurofeedback could be affirmed. More rigorous studies are needed to establish the applicability and efficacy of biofeedback and neurofeedback in the management of psychopathologies.