Comparing engage with PST in late-life major depression: a preliminary report.
Comparing engage with PST in late-life major depression: a preliminary report.
复制标题
DOI：
10.1016/j.jagp.2014.06.008
复制
发表时间：
2015-05
影响因子：
7.2
通讯作者：
Arean, Patricia A.
中科院分区：
文献类型：
--
作者：
Alexopoulos, George S.;Raue, Patrick J.;Kiosses, Dimitris N.;Seirup, Joanna K.;Banerjee, Samprit;Arean, Patricia A.
心理治疗的复杂性一直是社区实施的障碍。我们使用研究领域标准共识作为指南来开发Engage，这是一种简化的、基于神经生物学的老年抑郁症心理疗法，可能与执业临床医生的技能集相匹配。这项概念验证研究测试了从事与问题解决疗法(PST)在减少抑郁症状、诱导缓解和改善残疾方面生物等同的假设。Engage假设正价系统的异常功能加剧了抑郁，并将“奖励暴露”(参与有意义的、有回报的活动)作为其主要干预措施。负性偏向、冷漠和情绪失调分别是负性配价、唤醒和调节以及认知控制系统异常的表现。只有在他们干扰奖励暴露的情况下，才会用简单的干预措施让他们每个人都参与进来。我们对39名患有单相重度抑郁症的老年人每周进行9次公开治疗。我们比较了他们的抑郁病程(Ham-D)、缓解率(Ham-D<；10)和残疾(WHODAS)与每周接受9次PST治疗的历史对照组(N=97)。社区社会工作者和研究治疗师需要的培训时间是PST的三分之一。在降低HAM-D和WHODAS方面，Engage不逊于PST。6周和9周的缓解率分别为18.2%和41.1%。PST的相应数字分别为13.7%和35.0%。这些初步观察表明，Engage在减少抑郁症状和残疾方面与PST具有类似的疗效，值得进行随机对照试验。
The complexity of psychotherapies has been a barrier to community implementation. We used the Research Domain Criteria consensus as a guide to develop Engage, a streamlined, neurobiology-based psychotherapy for late-life depression that may match the skill set of practicing clinicians. This proof of concept study tested the hypotheses that Engage is bioequivalent to Problem Solving Therapy (PST) in reducing depressive symptoms, inducing remission, and ameliorating disability. Engage assumes that abnormal function of the positive valence systems fuels depression and uses “reward exposure” (engagement in meaningful, rewarding activities) as its principal intervention. Negativity bias, apathy, and emotional dysregulation are expressions of abnormalities in the negative valence, arousal and regulatory, and cognitive control systems respectively. Engage targets each of them with simple interventions only if they interfere with reward exposure. We treated openly with 9 weekly sessions of Engage 39 older adults with unipolar major depression. We compared their course of depression (HAM-D), remission rate (HAM-D<10), and disability (WHODAS) with those of a historical comparison group (N=97) treated with 9 weekly sessions of PST. Community social workers and research therapists required one third as much training time in Engage as in PST. Engage was non-inferior to PST in reducing HAM-D and WHODAS. Remission rates for Engage at 6 and 9 weeks were 18.2%, and 41.1%. The corresponding figures for PST were 13.7% and 35.0%. These initial observations suggest that Engage has comparable efficacy with PST in reducing depressive symptoms and disability and warrants a randomized controlled trial.
登录
查看更多内容
DOI：
10.1176/appi.ajp.2008.08081201
发表时间：
2009-06
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Pizzagalli DA;Holmes AJ;Dillon DG;Goetz EL;Birk JL;Bogdan R;Dougherty DD;Iosifescu DV;Rauch SL;Fava M
通讯作者：
Fava M
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
3.7
作者：
Maier S;Szalkowski A;Kamphausen S;Perlov E;Feige B;Blechert J;Philipsen A;van Elst LT;Kalisch R;Tüscher O
通讯作者：
Tüscher O
影响因子：
6.6
作者：
Alexopoulos, George S.;Hoptman, Matthew J.;Yuen, Genevieve;Kanellopoulos, Dora;Seirup, Joanna K.;Lim, Kelvin O.;Gunning, Faith M.
通讯作者：
Gunning, Faith M.
影响因子：
--
作者：
Alexopoulos, George S.;Raue, Patrick J.;Kiosses, Dimitris N.;Mackin, R. Scott;Kanellopoulos, Dora;McCulloch, Charles;Arean, Patricia A.
通讯作者：
Arean, Patricia A.