How durable is the effect of low intensity CBT for depression and anxiety? Remission and relapse in a longitudinal cohort study
How durable is the effect of low intensity CBT for depression and anxiety? Remission and relapse in a longitudinal cohort study
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DOI：
10.1016/j.brat.2017.04.006
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发表时间：
2017-07-01
影响因子：
4.1
通讯作者：
Delgadillo, Jaime
中科院分区：
文献类型：
--
作者：
Ali, Shehzad;Rhodes, Laura;Delgadillo, Jaime
背景：抑郁症和焦虑症是容易复发的疾病，即使在药物治疗或心理治疗取得成功后也是如此。认知行为疗法(CBT)是已知的预防复发的方法，但很少有证据表明低强度CBT(LiCBT)后缓解的持久性。方法：这项研究旨在检查完成常规LiCBT后12个月的复发率。439名LiCBT患者在治疗后12个月内每月提供抑郁(PHQ-9)和焦虑(GAD-7)测量，症状缓解。在控制患者特征的同时进行生存分析以建立复发时间模型。结果：总体而言，53%的病例在1年内复发。在这些复发事件中，大多数(79%)发生在治疗后的前6个月内。治疗结束时出现残留抑郁症状(PHQ-9=5~9)的患者，其复发风险显著较高(风险比=1.9，p<；0.001)。结论：LCBT术后复发率高，强调了预防复发的必要性，尤其是对那些有残留抑郁症状的患者。(C)2017爱思唯尔有限公司。保留所有权利。
Background: Depression and anxiety disorders are relapse-prone conditions, even after successful treatment with pharmacotherapy or psychotherapy. Cognitive behavioural therapy (CBT) is known to prevent relapse, but there is little evidence of the durability of remission after low intensity forms of CBT (LiCBT).Method: This study aimed to examine relapse rates 12 months after completing routinely-delivered LiCBT. A cohort of 439 LiCBT completers with remission of symptoms provided monthly depression (PHQ-9) and anxiety (GAD-7) measures during 12 months after treatment. Survival analysis was conducted to model time-to-relapse while controlling for patient characteristics.Results: Overall, 53% of cases relapsed within 1 year. Of these relapse events, the majority (79%) occurred within the first 6 months post-treatment. Cases reporting residual depression symptoms (PHQ-9 = 5 to 9) at the end of treatment had significantly higher risk of relapse (hazard ratio = 1.90, p < 0.001).Conclusions: The high rate of relapse after LiCBT highlights the need for relapse prevention, particularly for those with residual depression symptoms. (C) 2017 Elsevier Ltd. All rights reserved.