Effective Components of TORDIA Cognitive-Behavioral Therapy for Adolescent Depression: Preliminary Findings
Effective Components of TORDIA Cognitive-Behavioral Therapy for Adolescent Depression: Preliminary Findings
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DOI：
10.1037/a0017411
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发表时间：
2009-12-01
影响因子：
5.9
通讯作者：
Brent, David A.
中科院分区：
文献类型：
--
作者：
Kennard, Betsy D.;Clarke, Greg N.;Brent, David A.
在本报告中，我们对青少年抗 SSRI 抑郁症治疗 (TORDIA) 研究进行了二次分析，以探讨特定认知行为疗法 (CBT) 治疗成分对结果的影响。在 TORDIA 中，334 名患有严重抑郁症的青少年（12 至 18 岁）对足够疗程的选择性血清素再摄取抑制剂 (SSRI) 药物治疗无效，被随机分配到药物转换组（替代 SSRI 或文拉法辛），并接受或不接受 12 周的辅助 CBT。进行超过 9 次 CBT 疗程的参与者获得充分治疗反应的可能性是进行 9 次或更少疗程的参与者的 2.5 倍。接受解决问题和社交技能治疗的 CBT 参与者（控制治疗次数和其他混杂变量），获得积极反应的可能性分别是 2.3 倍和 2.6 倍。这些初步研究结果强调了接受足够数量的治疗以获得足够的临床反应的重要性。最后，社交技能和解决问题可能是青少年抑郁症认知行为治疗中的积极因素，那些治疗严重抑郁症青少年的人应该在治疗时考虑到这一点。
In this report, we conducted a secondary analysis of the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) study to explore the impact of specific cognitive-behavioral therapy (CBT) treatment components on outcome. In TORDIA, 334 youths (ages 12 to 18 years) with major depressive disorder who had failed to respond to an adequate course of selective serotonin reuptake inhibitor (SSRI) medication were randomized to a medication switch (either to an alternative SSRI or venlafaxine) with or without 12 weeks of adjunctive CBT. Participants who had more than 9 CBT sessions were 2.5 times more likely to have adequate treatment response than those who had 9 or fewer sessions. CBT participants who received problem-solving and social skills treatment components, controlling for number of sessions and other confounding variables, were 2.3 and 2.6 times, respectively, more likely to have a positive response. These preliminary findings underscore the importance of receiving an adequate number of sessions to attain an adequate clinical response. Finally, social skills and problem solving may be active elements in CBT for adolescent depression and should be considered in treatment by those working with seriously depressed youths.