Predictors of outcome for telephone and face-to-face administered cognitive behavioral therapy for depression.
Predictors of outcome for telephone and face-to-face administered cognitive behavioral therapy for depression.
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电话和面对面进行的抑郁症认知行为疗法结果的预测因素。
DOI：
10.1017/s0033291715001208
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发表时间：
2015
影响因子：
6.9
通讯作者：
Mohr,DC
中科院分区：
文献类型：
--
作者：
Stiles-Shields,C;Corden,ME;Kwasny,MJ;Schueller,SM;Mohr,DC
背景认知行为疗法（CBT）可以通过各种方式有效地提供，包括电话（T-CBT）和面对面（FtF-CBT）。本研究旨在探讨T-CBT和FtF-CBT治疗抑郁症的预后预测因素。方法将325名抑郁症患者随机分为T-CBT组和FtF-CBT组，每组18次，每次45 min。采用汉密尔顿抑郁评定量表（HAMD）和患者健康问卷-9（PHQ-9）测量抑郁严重程度。在治疗结束时（第18周），对基线参与者人口统计学和预测抑郁结局的心理特征、HAMD和PHQ-9进行分类和回归树（CART）分析。结果HAMD和PHQ-9的人口学和心理学特征分别准确识别出85.3%和85.0%的治疗应答者和85.7%和85.0%的治疗无应答者。应对自我效能（CSE）量表预测HAMD和PHQ-9的结果;那些中度至高度CSE可能响应没有其他变量影响预测。在低CSE的患者中，抑郁严重程度影响反应。社会支持，身体功能，就业出现的预测只有HAMD，和性别预测的PHQ-9的反应。治疗方法（即电话或面对面）不影响结局预测。结论研究结果表明，改善抑郁症的预测因素是相似的治疗方式。最重要的是，中到高水平的CSE显著增加了T-CBT和FtF-CBT的反应机会。在低CSE患者中，抑郁症状严重程度较低的患者更有可能在治疗中表现良好。
Background Cognitive behavioral therapy (CBT) can be delivered efficaciously through various modalities, including telephone (T-CBT) and face-to-face (FtF-CBT). The purpose of this study was to explore predictors of outcome in T-CBT and FtF-CBT for depression. Method A total of 325 depressed participants were randomized to receive eighteen 45-min sessions of T-CBT or FtF-CBT. Depression severity was measured using the Hamilton Depression Rating Scale (HAMD) and the Patient Health Questionnaire-9 (PHQ-9). Classification and regression tree (CART) analyses were conducted with baseline participant demographics and psychological characteristics predicting depression outcomes, HAMD and PHQ-9, at end of treatment (week 18). Results The demographic and psychological characteristics accurately identified 85.3% and 85.0% of treatment responders and 85.7% and 85.0% of treatment non-responders on the HAMD and PHQ-9, respectively. The Coping self-efficacy (CSE) scale predicted outcome on both the HAMD and PHQ-9; those with moderate to high CSE were likely to respond with no other variable influencing that prediction. Among those with low CSE, depression severity influenced response. Social support, physical functioning, and employment emerged as predictors only for the HAMD, and sex predicted response on the PHQ-9. Treatment delivery method (i.e. telephone or face-to-face) did not impact the prediction of outcome. Conclusions Findings suggest that the predictors of improved depression are similar across treatment modalities. Most importantly, a moderate to high level of CSE significantly increases the chance of responding in both T-CBT and FtF-CBT. Among patients with low CSE, those with lower depressive symptom severity are more likely to do well in treatment.