A randomized controlled trial examining the impact of individual trauma-focused therapy for individuals receiving group treatment for depression
A randomized controlled trial examining the impact of individual trauma-focused therapy for individuals receiving group treatment for depression
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DOI：
10.1111/papt.12268
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发表时间：
2021-03-01
影响因子：
3.4
通讯作者：
Lee, Christopher William
中科院分区：
文献类型：
--
作者：
Dominguez, Sarah;Drummond, Peter;Lee, Christopher William
目的不良生活事件与抑郁的可能性增加和预后不良有关。以创伤为中心的治疗（TFT）似乎在减少共病抑郁症状方面有效。因此，本研究的目的是评估TFT的有效性的个人与抑郁症的主要诊断的厌恶事件的记忆。方法进行了一项随机对照试验，招募了49名参与者从一个为期10天的门诊小组计划。所有参与者均表现出抑郁症状，其中一个亚组（80%）符合DSM-5重度抑郁发作的标准。参与者接受常规治疗（TAU）;三个额外的个人创伤集中课程;或三个额外的个人自信训练课程。参与者进行了评估，关于抑郁症的诊断和相关symptoms.Results的参与者与抑郁症发作，除了创伤为重点的会议显着增加缓解的可能性相比，TAU，或额外的自信心训练。虽然在治疗后抑郁症状变化方面没有显著的治疗差异，但治疗后6周，接受辅助治疗的患者比接受TAU的患者更有可能维持治疗获益。此外，在12周的随访中，接受TFT的参与者报告的抑郁症状明显少于接受自信training.Conclusions的参与者，而结果的差异是最小的治疗后立即，治疗组之间的差异随着时间的推移而增加。因此，对于完成抑郁症治疗小组计划的人来说，只需三次额外的TFT会议就可能对症状变化产生积极影响。从业者指出抑郁症是全球残疾的最大原因。不良经历与抑郁症的可能性增加有关，更严重的症状和不良的治疗结果后，循证干预。只有三个创伤-针对性的治疗可以改善接受集体认知行为疗法的个人在抑郁症诊断和相关症状方面的治疗结果。
Objectives Adverse life events are associated with increased likelihood of depression and poorer prognosis. Trauma-focused treatments (TFT) appear to be effective in decreasing comorbid depressive symptoms. Accordingly, the aim of this study was to evaluate the effectiveness of a TFT on the memories of aversive events for individuals with a primary diagnosis of depression.Methods A randomized controlled trial was conducted with 49 participants recruited from a 10-day outpatient group programme. All participants showed symptoms of depression with a subgroup (80%) meeting the DSM-5 criteria for a major depressive episode. Participants received treatment as usual (TAU); three additional individual trauma-focused sessions; or three additional individual assertiveness training sessions. Participants were assessed with regards to depression diagnosis and related symptoms.Results For participants with a major depressive episode, the addition of trauma-focused sessions significantly increased the likelihood of remission when compared to TAU, or additional assertiveness training. While no significant treatment difference was noted in depressive symptom change post-treatment, six weeks after treatment those who received an adjunct treatment were more likely to maintain treatment gains than those who received TAU. Furthermore, at 12-week follow-up, participants who received a TFT reported significantly fewer depressive symptoms than those who received assertiveness training.Conclusions While differences in outcomes were minimal immediately post-treatment, differences among treatment groups increased over time. Thus, as few as three additional TFT sessions may impact positively on symptom change for people completing a group programme for the treatment of depression.Practitioner pointsDepression is the greatest cause of disability worldwide.Adverse experiences are linked with an increased likelihood of depression, more severe symptoms and poor treatment outcomes following evidence-based interventions.As few as three trauma-focused sessions can improve treatment outcomes in terms of depression diagnosis and related symptoms for individuals receiving group cognitive behavioural therapy.