Depression and traumatic brain injury: symptom profiles of patients treated with cognitive-behavioral therapy or supportive psychotherapy
Depression and traumatic brain injury: symptom profiles of patients treated with cognitive-behavioral therapy or supportive psychotherapy
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DOI：
10.2217/npy.13.75
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发表时间：
2013-12-01
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影响因子：
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通讯作者：
Gordon, Wayne
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文献类型：
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作者：
D'Antonio, Emily;Tsaousides, Theodore;Gordon, Wayne
目的：本研究旨在探讨认知行为疗法(CBT)和支持性心理疗法(SPT)对寻求治疗重度抑郁障碍(MDD)的创伤性脑损伤(TBI)患者抑郁症状的不同治疗效果。方法：研究对象为符合MDD诊断标准的颅脑损伤患者，作为一项比较脑外伤后MDD治疗方法的大型随机对照试验的一部分，他们接受了CBT(n=22)或SPT(n=22)。参与者的平均年龄为48.8岁(标准差=10.2)，其中571%是女性，57.5%是高加索人，20%是西班牙裔，15%是非洲裔美国人。主要结果测量为Beck抑郁量表II(BDI-II)。结果：所有参与者在基线时的BDI-II总分平均为25分(标准差=10.0)。无论是在基线还是在治疗结束时，治疗组之间的BDI-II总分都没有显著差异。接受CBT治疗的参与者报告说，悲伤、失去兴趣和对性行为失去兴趣的情况有了显著改善，而接受SPT治疗的参与者报告说，焦虑和易怒的症状有了显著改善。结论：SPT可以更好地针对行为去抑制症状(激越和易怒)，而CBT可能更好地针对情绪症状(悲伤)及其行为表现(失去兴趣和对性生活失去兴趣)。
Aims: This study aimed to examine the differential treatment effects of cognitive-behavioral therapy (CBT) and supportive psychotherapy (SPT) on self-reported symptoms of depression in individuals with traumatic brain injury (TBI) who sought treatment for major depressive disorder (MDD). Methods: Participants were individuals with a documented TBI meeting criteria for MDD who, as part of a larger randomized controlled trial comparing treatments for MDD after TBI, received CBT (n = 22) or SPT (n = 22). The average age of participants was 48.8 years (standard deviation = 10.2), 57.1% were female, 57.5% were Caucasian, 20% were Hispanic and 15% were African-American. The main outcome measure was the Beck Depression InventoryII (BDI-II). Results: Mean total BDI-II score for all participants combined at baseline was 25 (standard deviation = 10.0). There were no significant differences in total BDI-II score between treatment groups at either baseline or at the end of treatment. Participants treated with CBT reported significant improvements in sadness, loss of interest and loss of interest in sex, while participants treated with SPT reported significant improvements in symptoms of agitation and irritability. Conclusion: SPT may better target symptoms of behavioral disinhibition (agitation and irritability), while CBT may better target mood symptoms (sadness) and their behavioral manifestations (loss of interest and loss of interest in sex).