Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression
Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression
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DOI：
10.1037/0022-006x.74.4.658
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发表时间：
2006-08-01
影响因子：
5.9
通讯作者：
Jacobson, Neil S.
中科院分区：
文献类型：
--
作者：
Dimidjian, Sona;Hollon, Steven D.;Jacobson, Neil S.
抗抑郁药物被认为是目前严重抑郁症的标准，认知疗法是研究最广泛的抑郁症心理社会治疗。然而，并不是所有的患者都想服用药物，认知疗法在试验中也没有表现出一致的疗效。此外，拆解设计表明，行为成分可以解释认知疗法的疗效。本研究通过将行为激活与认知疗法和抗抑郁药物进行比较，在随机安慰剂对照设计中，在患有重度抑郁症的成年人（N = 241）中测试了行为激活的疗效。此外，它还检查了初始严重程度作为治疗结果调节剂的重要性。在更严重的抑郁症患者中，行为激活与抗抑郁药物相当，并且都显著优于认知治疗。目前的治疗指南和传播的评价，这些研究结果的影响进行了讨论。
Antidepressant medication is considered the current standard for severe depression, and cognitive therapy is the most widely investigated psychosocial treatment for depression. However, not all patients want to take medication, and cognitive therapy has not demonstrated consistent efficacy across trials. Moreover, dismantling designs have suggested that behavioral components may account for the efficacy of cognitive therapy. The present study tested the efficacy of behavioral activation by comparing it with cognitive therapy and antidepressant medication in a randomized placebo-controlled design in adults with major depressive disorder (N = 241). In addition, it examined the importance of initial severity as a moderator of treatment outcome. Among more severely depressed patients, behavioral activation was comparable to antidepressant medication, and both significantly outperformed cognitive therapy. The implications of these findings for the evaluation of current treatment guidelines and dissemination are discussed.