Six-year outcome of cognitive behavior therapy for prevention of recurrent depression
Six-year outcome of cognitive behavior therapy for prevention of recurrent depression
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DOI：
10.1176/appi.ajp.161.10.1872
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发表时间：
2004-10-01
影响因子：
17.7
通讯作者：
Grandi, S
中科院分区：
文献类型：
--
作者：
Fava, GA;Ruini, C;Grandi, S
目的：很少有研究使用非药物策略来预防抑郁症复发。在对复发性抑郁症进行为期2年的随访中发现，对残留症状进行认知行为治疗的复发率明显低于临床管理。本研究的目的是对认知行为治疗与临床管理进行为期6年的随访。
方法：40名经抗抑郁药物成功治疗的复发性重度抑郁症患者被随机分配到对残留症状进行认知行为治疗组（辅以生活方式调整和幸福疗法）或临床管理组。两组均逐渐减少并停用抗抑郁药物。进行了为期6年的随访。在此期间，除非复发，否则不使用抗抑郁药物。
结果：在为期6年的随访中，认知行为治疗组的复发率（40%）明显低于临床管理组（90%）。当考虑多次复发时，接受认知行为治疗的组与临床管理组相比，复发次数明显更少。
结论：结果表明，药物治疗后依次使用认知行为治疗可能会改善复发性抑郁症的长期预后。相当比例的复发性抑郁症患者可能能够成功停药，并通过有针对性的心理治疗疗程至少保持6年的良好状态。
Objective: A paucity of studies use non-pharmacological strategies for preventing recurrence in depression. Cognitive behavior treatment of residual symptoms was found to yield a significantly lower relapse rate than clinical management in recurrent depression at a 2-year follow-up. The objective of this investigation was to provide a 6-year follow-up of cognitive behavior treatment versus clinical management.Method: Forty patients with recurrent major depression who had been successfully treated with antidepressant drugs were randomly assigned to either cognitive behavior treatment of residual symptoms (supplemented by lifestyle modification and well-being therapy) or clinical management. In both groups, antidepressant drugs were tapered and discontinued. A 6-year follow-up was undertaken. During this period, no antidepressant drugs were used unless a relapse ensued.Results: Cognitive behavior treatment resulted in a significantly lower relapse rate (40%) at a 6-year follow-up than did clinical management (90%). When multiple recurrences were considered, the group that received cognitive behavior treatment had a significantly lower number of relapses in comparison with the clinical management group.Conclusions: The results suggest that the sequential use of cognitive behavior treatment after pharmacotherapy may improve the long-term outcome in recurrent depression. A significant proportion of patients with recurrent depression might be able to withdraw from medication successfully and to stay well for at least 6 years with a focused course of psychotherapy.