Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators.
Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators.
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DOI：
10.1016/j.psc.2010.04.005
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发表时间：
2010-09
影响因子：
1.7
通讯作者：
Hollon, Steven D.
中科院分区：
文献类型：
--
作者：
Driessen, Ellen;Hollon, Steven D.
认知行为疗法（CBT）在抑郁症的急性治疗中是有效的，并且当以恰当的方式实施时，对于更严重的单相抑郁症患者来说，它可能是抗抑郁药物（ADM）的一种可行替代方案。CBT也可作为双相情感障碍患者药物治疗的辅助手段，尽管相关研究较少且并不完全一致。CBT似乎确实具有持久的效果，能在积极治疗结束后防止后续的复发，这是药物所不具备的。需要重复验证的单项研究表明，已婚或失业的患者，或者有更多既往生活事件的患者，可能在CBT治疗中比在ADM治疗中效果更好，没有合并轴II障碍的患者可能也是如此，而合并轴II障碍的患者似乎在ADM治疗中比在CBT治疗中效果更好。也有迹象表明，CBT可能通过理论所规定的过程起作用，从而引起认知的改变，进而介导抑郁症随后的改善以及治疗结束后免于复发，尽管在这方面的证据还不是确凿的。
Cognitive behavior therapy (CBT) is efficacious in the acute treatment of depression and may provide a viable alternative to antidepressant medications (ADM) for even more severely depressed unipolar patients when implemented in a competent fashion. CBT also may be of use as an adjunct to medication treatment for bipolar patients, although the studies are few and not wholly consistent. CBT does appear to have an enduring effect that protects against subsequent relapse and recurrence following the end of active treatment, something that cannot be said for medications. Single studies that require replication suggest that patients who are married or unemployed or who have more antecedent life events may do better in CBT than in ADM, as might patients who are free from comorbid Axis II disorders, whereas patients with comorbid Axis II disorders appear to do better in ADM than in CBT. There also are indications that CBT may work through processes specified by theory to produce change in cognition that in turn mediate subsequent change in depression and freedom from relapse following treatment termination, although evidence in that regard is not yet conclusive.
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