Psychosocial functioning in patients with Treatment-Resistant Depression after group cognitive behavioral therapy.
Psychosocial functioning in patients with Treatment-Resistant Depression after group cognitive behavioral therapy.
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DOI：
10.1186/1471-244x-10-22
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发表时间：
2010-03-16
期刊：
影响因子：
4.4
通讯作者：
Yamawaki S
中科院分区：
文献类型：
--
作者：
Matsunaga M;Okamoto Y;Suzuki S;Kinoshita A;Yoshimura S;Yoshino A;Kunisato Y;Yamawaki S
尽管难治性抑郁症（TRD）患者的社会功能通常受损，但很少有研究调查心理社会治疗对这些患者的有效性。我们研究了在药物治疗中加入团体认知行为疗法 (group-CBT) 是否会改善轻度 TRD 患者的抑郁症状和社会功能，以及任何改善是否会维持一年以上。 43 名 TRD 患者接受了每周 12 次的团体 CBT 治疗。在基线、治疗终止和 12 个月随访时，对患者进行总体功能评估量表 (GAF)、36 项简短健康调查 (SF-36)、汉密尔顿抑郁量表 (HRSD)、功能失调态度量表 (DAS) 和自动思维问卷修订版 (ATQ-R) 进行评估。 38名患者完成治疗；五人退学。对于完成治疗的患者，治疗后 GAF 和 SF-36 评分显着高于基线评分。治疗后 HRSD、DAS 和 ATQ-R 评分显着降低。因此，患者的心理社会功能和情绪症状的所有测量结果均得到改善。 20 名患者参与了为期 12 个月的随访。完成团体 CBT 后 12 个月，他们的心理社会功能、抑郁症状和认知功能障碍持续改善。这些发现表明，在药物治疗中添加认知行为团体疗法对轻度抑郁患者的抑郁症状和社会功能有积极作用，显示出治疗抵抗。
Although patients with Treatment Resistant Depression (TRD) often have impaired social functioning, few studies have investigated the effectiveness of psychosocial treatment for these patients. We examined whether adding group cognitive behavioral therapy (group-CBT) to medication would improve both the depressive symptoms and the social functioning of patient with mild TRD, and whether any improvements would be maintained over one year. Forty-three patients with TRD were treated with 12 weekly sessions of group-CBT. Patients were assessed with the Global Assessment of Functioning scale (GAF), the 36-item Short-Form Health Survey (SF-36), the Hamilton Rating Scale for Depression (HRSD), the Dysfunctional Attitudes Scale (DAS), and the Automatic Thought Questionnaire-Revised (ATQ-R) at baseline, at the termination of treatment, and at the 12-month follow-up. Thirty-eight patients completed treatment; five dropped out. For the patients who completed treatment, post-treatment scores on the GAF and SF-36 were significantly higher than baseline scores. Scores on the HRSD, DAS, and ATQ-R were significantly lower after the treatment. Thus patients improved on all measurements of psychosocial functioning and mood symptoms. Twenty patients participated in the 12-month follow-up. Their improvements for psychosocial functioning, depressive symptoms, and dysfunctional cognitions were sustained at 12 months following the completion of group-CBT. These findings suggest a positive effect that the addition of cognitive behavioural group therapy to medication on depressive symptoms and social functioning of mildly depressed patients, showing treatment resistance.