Antidepressant medications v. cognitive therapy in people with depression with or without personality disorder
Antidepressant medications v. cognitive therapy in people with depression with or without personality disorder
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DOI：
10.1192/bjp.bp.107.037234
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发表时间：
2008-02-01
影响因子：
10.5
通讯作者：
Hollon, Steven D.
中科院分区：
文献类型：
--
作者：
Fournier, Jay C.;DeRubeis, Robert J.;Hollon, Steven D.
目的通过对180例门诊抑郁症患者进行随机分组，观察抗抑郁药物和认知治疗对抑郁症患者人格障碍的影响。在12个月的时间里，随机将药物应答者分配给继续用药或安慰剂，并与认知治疗应答者进行比较。结果人格障碍状态导致16周时反应不同，有个性障碍者为66%比44%(抗抑郁药物与认知治疗分别为)，非人格障碍者为49%比70%(抗抑郁药物与认知治疗分别为)。对于人格障碍患者，在12个月的随访中，认知治疗和继续药物治疗组的持续应答率几乎相同(38%)。人格障碍患者停药后持续有效率最低(6%)。尽管人格障碍患者对认知疗法的反应很差，但几乎所有有反应的人都保持了他们的反应。结论在两种有效的抑郁症治疗方法中，共病人格障碍与不同的初始应答率和持续应答率有关。利益声明R.C.S得到了葛兰素史克制药公司的赠款支持。在致谢中详细说明了资金。
BackgroundThere is conflicting evidence about comorbid personality pathology in depression treatments.AimsTo test the effects of antidepressant drugs and cognitive therapy in people with depression distinguished by the presence or absence of personality disorder.MethodRandom assignment of 180 out-patients with depression to 16 weeks of antidepressant medication or cognitive therapy. Random assignment of medication responders to continued medication or placebo, and comparison with cognitive therapy responders over a 12-month period.ResultsPersonality disorder status led to differential response at 16 weeks, 66% v. 44% (antidepressants v. cognitive therapy respectively) for people with personality disorder, and 49% v. 70% (antidepressants v. cognitive therapy respectively) for people without personality disorder. For people with personality disorder, sustained response rates over the 12-month follow-up were nearly identical (38%) in the prior cognitive therapy and continuation-medication treatment arms. People with personality disorder withdrawn from medication evidenced the lowest sustained response rate (6%). Despite the poor response of people with personality disorder to cognitive therapy, nearly all those who did respond sustained their response.ConclusionsComorbid personality disorder was associated with differential initial response rates and sustained response rates for two well-validated treatments for depression.Declaration of interestR.C.S has received grant support from GlaxoSmithKline Pharmaceuticals. Funding detailed in Acknowledgements.