A randomized trial of a group cognitive intervention for preventing depression in adolescent offspring of depressed parents
A randomized trial of a group cognitive intervention for preventing depression in adolescent offspring of depressed parents
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DOI：
10.1001/archpsyc.58.12.1127
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发表时间：
2001-12-01
影响因子：
--
通讯作者：
Seeley, J
中科院分区：
文献类型：
--
作者：
Clarke, GN;Hornbrook, M;Seeley, J
背景：父母患有抑郁症的青少年子女患抑郁症的风险很高。认知重建疗法有希望防止进展为depressive episodes.Methods：一项随机对照试验进行，以防止抑郁症发作的风险后代（13-18岁）的成年人治疗抑郁症的健康维护组织（HMO）。潜在的成人病例是通过审查HMO药房记录的抗抑郁药物的分配和精神健康预约系统发现的。对病历进行了审查，以确定抑郁症的诊断。由治疗医生签署的招募信邮寄给成年人。符合条件的后代有亚诊断抑郁症状，不足以满足情感障碍和/或既往心境障碍的完整DSM-III-R标准。这些年轻人被随机分配到常规的HMO护理（n=49）或常规护理加15次小组认知治疗预防程序（n=45）。结果：我们检测到流行病学研究中心抑郁量表（P= 0.005）和功能评分的全球评估（P= 0.04）的显着治疗时间（程序）效果。在中位15个月的随访中，对重性抑郁发作的生存分析发现，（P=.003）对于实验条件（9.3%的累积重度抑郁症发病率）与常规护理对照条件相比（28.8%）。一个简短的团体认知治疗预防计划可以降低有抑郁症病史的父母的青少年后代患抑郁症的风险。
Background: Adolescent offspring of depressed parents are at high risk for development of depression. Cognitive restructuring therapy holds promise for preventing progression to depressive episodes.Methods: A randomized, controlled trial was conducted to prevent depressive episodes in at-risk offspring (aged 13-18 years) of adults treated for depression in a health maintenance organization (HMO). Potential adult cases were found by reviewing the HMO pharmacy records for dispensation of antidepressant medication and the mental health appointment system. Medical charts were reviewed for a depression diagnosis. Recruitment letters signed by treating physicians were mailed to adults. Eligible offspring had subdiagnostic depressive symptoms insufficient to meet full DSM-III-R criteria for affective disorder and/or a past mood disorder. These youth were randomized to usual HMO care (n=49) or usual care plus a 15-session group cognitive therapy prevention program (n=45).Results: We detected significant treatment-by-time (program) effects for the Center for Epidemiological Studies Depression Scale (P=.005) and the Global Assessment of Functioning scores (P=.04). Survival analysis of incident major depressive episodes during a median 15-month follow-up found a significant advantage (P=.003) for the experimental condition (9.3% cumulative major depression incidence) compared with the usual-care control condition (28.8%).Conclusion: A brief, group cognitive therapy prevention program can reduce the risk for depression in the adolescent offspring of parents with a history of depression.