Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression
Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression
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DOI：
10.1037/0022-006x.76.3.468
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发表时间：
2008-06-01
影响因子：
5.9
通讯作者：
Gollan, Jackie K.
中科院分区：
文献类型：
--
作者：
Dobson, Keith S.;Dimidjian, Sona;Gollan, Jackie K.
这项研究跟踪了一项针对成年重度抑郁症患者的随机对照试验的治疗反应者。与接受过既往行为激活、既往认知治疗或继续用药的患者相比，接受过药物治疗但停用安慰剂的患者在1年的随访中复发率更高。在第2年随访中，既往心理治疗在预防复发方面也优于停药治疗上级。具体的比较表明，先前暴露于认知治疗的患者在治疗终止后复发的可能性显著低于退出药物治疗的患者，并且先前暴露于行为激活的患者相对于退出药物治疗的患者几乎一样好，尽管差异没有显著差异。行为激活和认知治疗之间的差异很小，在整个2年的随访中没有显著差异，每种治疗至少与继续用药一样有效。这些发现表明，行为激活可能几乎与认知疗法一样持久，并且这两种心理疗法在治疗抑郁症方面都是药物治疗的更便宜和更持久的替代品。
This study followed treatment responders from a randomized controlled trial of adults with major depression. Patients treated with medication but withdrawn onto pill-placebo had more relapse through I year of follow-up compared to patients who received prior behavioral activation, prior cognitive therapy, or continued medication. Prior psychotherapy was also superior to medication withdrawal in the prevention of recurrence across the 2nd year of follow-up. Specific comparisons indicated that patients previously exposed to cognitive therapy were significantly less likely to relapse following treatment termination than patients withdrawn from medication, and patients previously exposed to behavioral activation did almost as well relative to patients withdrawn from medication, although the difference was not significantly different. Differences between behavioral activation and cognitive therapy were small in magnitude and not significantly different across the full 2-year follow-up, and each therapy was at least as efficacious as the continuation of medication. These findings suggest that behavioral activation may be nearly as enduring as cognitive therapy and that both psychotherapies are less expensive and longer lasting alternatives to medication in the treatment of depression.