Relapse prevention in major depressive disorder: Mindfulness-based cognitive therapy versus an active control condition.
Relapse prevention in major depressive disorder: Mindfulness-based cognitive therapy versus an active control condition.
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DOI：
10.1037/ccp0000050
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发表时间：
2015-10
影响因子：
5.9
通讯作者：
Mauss IB
中科院分区：
文献类型：
--
作者：
Shallcross AJ;Gross JJ;Visvanathan PD;Kumar N;Palfrey A;Ford BQ;Dimidjian S;Shirk S;Holm-Denoma J;Goode KM;Cox E;Chaplin W;Mauss IB
我们评估了基于正念的认知疗法（MBCT）与主动控制条件（ACC）在预防抑郁症复发、减少抑郁症状和改善生活满意度方面的比较有效性。92名患有残余抑郁症状的重度抑郁症缓解期参与者被随机分配至8周MBCT或经验证的ACC，该ACC在结构上等同于MBCT和非特异性效应的对照组（例如，与促进者的互动，感知的社会支持，治疗结果预期）。这两项干预措施都是根据其出版的手册进行的。意向治疗分析表明，在60周的随访中，MBCT和ACC在抑郁症复发率或复发时间方面没有差异。两组都经历了抑郁症状的显著和同等程度的减轻和生活满意度的改善。一个显着的二次交互作用（组x时间）表明，抑郁症状减轻的模式不同组之间。ACC在干预后立即出现症状减轻，然后在60周的随访中逐渐增加。MBCT组经历了逐渐线性症状减轻。生活满意度的模式是相同的，但只有轻微的显着性。MBCT没有不同的ACC抑郁症复发率，症状减轻，或生活满意度，这表明MBCT是没有更有效的预防抑郁症复发和减少抑郁症状比ACC.Differences的积极组成部分的抑郁症状改善的轨迹表明，获得的干预特定的技能可能与治疗效益的差异率。这项研究表明，比较心理治疗干预积极控制条件的重要性。
We evaluated the comparative effectiveness of Mindfulness-based cognitive therapy (MBCT) versus an active control condition (ACC) for depression relapse prevention, depressive symptom reduction, and improvement in life satisfaction. Ninety-two participants in remission from Major Depressive Disorder with residual depressive symptoms were randomized to either an 8-week MBCT or a validated ACC that is structurally equivalent to MBCT and controls for non-specific effects (e.g., interaction with a facilitator, perceived social support, treatment outcome expectations). Both interventions were delivered according to their published manuals. Intention-to-treat analyses indicated no differences between MBCT and ACC in depression relapse rates or time to relapse over a 60-week follow-up. Both groups experienced significant and equal reductions in depressive symptoms and improvements in life satisfaction. A significant quadratic interaction (group x time) indicated that the pattern of depressive symptom reduction differed between groups. The ACC experienced immediate symptom reduction post-intervention and then a gradual increase over the 60-week follow-up. The MBCT group experienced a gradual linear symptom reduction. The pattern for life satisfaction was identical but only marginally significant. MBCT did not differ from an ACC on rates of depression relapse, symptom reduction, or life satisfaction, suggesting that MBCT is no more effective for preventing depression relapse and reducing depressive symptoms than the active components of the ACC. Differences in trajectory of depressive symptom improvement suggest that the intervention-specific skills acquired may be associated with differential rates of therapeutic benefit. This study demonstrates the importance of comparing psychotherapeutic interventions to active control conditions.