Cognitive-behavioral management of drug-resistant major depressive disorder
Cognitive-behavioral management of drug-resistant major depressive disorder
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DOI：
10.4088/jcp.v58n0608b
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发表时间：
1997-06-01
影响因子：
5.3
通讯作者：
Rafanelli, C
中科院分区：
文献类型：
--
作者：
Fava, GA;Savron, G;Rafanelli, C
背景资料：认知行为治疗耐药的抑郁症的应用已收到很少research attention.Method：19例患者谁未能响应至少两个试验的抗抑郁药的足够的剂量和持续时间进行了治疗的认知行为方法在一个开放的trial.Results：3例患者退出治疗。其余16名患者治疗后抑郁症临床访谈评分显著降低（p <0.001）。12例患者在试验结束时被判定为缓解;其中仅1例患者在2年随访时复发。抗抑郁药在12名患者中有8名对认知行为治疗有反应，其中8名停用。结论：这些初步结果表明，在将抑郁症发作标记为“难治性”或“治疗抵抗性”之前，应进行由经验丰富的治疗师进行的认知行为治疗试验。后面这些术语只有在心理治疗努力已经做出时才适用。在此之前，将抑郁症定义为“药物难治性”或“药物治疗抵抗性”似乎更合适。''
Background: The application of cognitive-behavioral treatment to drug-resistant major depression has received little research attention.Method: Nineteen patients who failed to respond to at least two trials of antidepressant drugs of adequate dosages and duration were treated by cognitive-behavioral methods in an open trial.Results: Three patients dropped out of treatment. The remaining 16 patients displayed a significant (p < .001) decrease in scores on the Clinical Interview for Depression after therapy. Twelve patients were judged to be in remission at the end of the trial; only 1 of these patients was found to have relapsed at a 2-year follow-up. Antidepressant drugs were discontinued in 8 of the 12 patients who responded to cognitive-behavioral treatment.Conclusion: These preliminary results suggest that a trial of cognitive-behavioral therapy by an experienced therapist should be performed before labeling an episode of major depression as ''refractory'' or ''treatment resistant.'' These latter terms should apply only when a psychotherapeutic effort has been made. Until then, it seems more appropriate to define depression as ''drug refractory'' or ''drug treatment resistant.''