IMPACT OF DEPRESSION ON TREATMENT EFFECTIVENESS AND GAINS MAINTENANCE IN SOCIAL PHOBIA: A NATURALISTIC STUDY OF COGNITIVE BEHAVIOR GROUP THERAPY
IMPACT OF DEPRESSION ON TREATMENT EFFECTIVENESS AND GAINS MAINTENANCE IN SOCIAL PHOBIA: A NATURALISTIC STUDY OF COGNITIVE BEHAVIOR GROUP THERAPY
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DOI：
10.1002/da.20390
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发表时间：
2009-03-01
影响因子：
7.4
通讯作者：
Hermesh, Haggai
中科院分区：
文献类型：
--
作者：
Marom, Sofi;Gilboa-Schechtman, Eva;Hermesh, Haggai
背景资料：在治疗结束后和1年随访时，在自然主义门诊环境中，研究了抑郁对社交恐惧症（SP）认知行为团体治疗（CBGT）的影响。方法：采用结构化访谈法对219例连续性SP门诊患者进行诊断。CBGT提供了18个1.5小时的每周会议。在治疗前和治疗后进行问卷调查和临床医生的评级。在1年随访时获得自我报告措施。主要的结果测量是Liebowitz社交焦虑量表。结果：CBGT被发现在减少社交焦虑（效应量= 1.23）和抑郁（效应量= 0.94）方面是有效的。一般性社交恐惧症（GSP）和特殊性社交恐惧症（SSP）患者的精神病理表现和对CBGT的反应不同。在治疗完成者中，44%的GSP和37%的SSP至少改善了50%，44%的GSP和87%的SSP在治疗结束时报告了痛苦和正常范围内的功能。在治疗开始时诊断为重度抑郁症（MDD）的SP中，SP症状在随访期间加重，而未诊断为MDD的SP在随访期间SP症状进一步缓解。CBGT在公共诊所提供给非选择性的，大多数未经药物治疗和共病的患者，是一种有效的治疗大多数SP患者。结论：CBGT发作时的MDD与较差的治疗反应无关，但可预测治疗终止后SP症状的加重。抑郁的SP可能需要额外的干预来维持CBGT的收益。SSP可能受益于强度低于GSP的CBGT。抑郁和焦虑26.289-300，2009。(C)2009威利-利斯公司
Background: The impact of depression on cognitive behavioral group therapy (CBGT) for social phobia (SP) in a naturalistic outpatient setting was examined after treatment termination and at 1-year follow-up. Methods: Consecutive SP outpatients (N = 219) were diagnosed using a structured interview. CBGT was provided in 18 1.5-hr weekly sessions. At pretreatment and posttreatment questionnaires and clinician ratings were administered. Self-report measures were obtained at 1-year follow-up. The main outcome measure was the Liebowitz Social Anxiety Scale. Results: CBGT was found to be effective in reducing both social anxiety (effect size = 1.23) as well as depression (effect size = 0.94). Individuals with generalized social phobia (GSP) and individuals with specific social phobia (SSP) differed in their presenting psychopathology and in their response to CBGT Among treatment completers, 44% GSPs and 37% SSPs achieved at least 50% improvement, and 44% GSPs and 87% SSPs reported distress and functioning within the normal range at the end of treatment. Among SPs diagnosed with major depressive disorder (MDD) at the onset of treatment, SP symptoms aggravated during the follow-up period, whereas SPs not diagnosed with MDD experienced a further alleviation of SP symptoms during follow-up. CBGT provided in a public clinic to non-selected, mostly unmedicated and comorbid patients, is an effective treatment for the majority of SP sufferers. Conclusions: MDD at the onset of CBGT was not associated with poorer treatment response, but predicted exacerbation of SP symptoms following treatment termination. Depressed SPs may need additional intervention to maintain CBGT gains. SSPs may benefit from less intensive CBGT than GSPs. Depression and Anxiety 26.289-300, 2009. (C) 2009 Wiley-Liss, Inc.