Cognitive-behavioural, pharmacological and psychosocial predictors of outcome during tapered discontinuation of benzodiazepine
Cognitive-behavioural, pharmacological and psychosocial predictors of outcome during tapered discontinuation of benzodiazepine
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DOI：
10.1002/cpp.556
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发表时间：
2008-01-01
影响因子：
3.6
通讯作者：
Bouthillier, Donald
中科院分区：
文献类型：
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作者：
O'Connor, Kieron;Marchand, Andre;Bouthillier, Donald
对86名希望停用苯二氮卓类药物且符合DSM-IV（精神疾病诊断与统计手册，第4版，美国心理学会，1994）焦虑症或失眠标准的参与者进行了临床、药理学和心理社会学评估。初始队列的41名参与者在相同的诊所环境中接受常规治疗（仅逐渐减量）加医生咨询。第二组45名参与者被随机分配到认知行为疗法（CBT）+逐渐减少组或团体支持（GS）+逐渐减少组。在3个月随访时，CBT和GS亚组的结局相当。意向治疗分析显示，CBT略优于GS组，CBT组在逐渐减量后表现出更高的自我效能。在所有86名参与者中，高基线水平的心理困扰，焦虑和剂量预测结果不佳，但自我效能的增加有助于成功的结果，特别是在那些最初基线预测因素不佳的人中。虽然与基线相比，在逐渐减少的停药的初始阶段，积极影响有所减少，但消极影响总体上没有显著增加。版权所有（C）2008约翰威利父子有限公司
Eighty-six participants wishing to stop benzodiazepine and who met DSM-IV(Diagnostic and Statistical Manual of Mental Disorders, 4th ed. American Psychological Association, 1994) criteria for anxiety disorder or insomnia were assessed pre- and post-taper on clinical, pharmacological and psychosocial measures. An initial cohort of 41 participants received treatment as usual (taper only) plus physician counselling in the same clinic setting. A second cohort of 45 participants were randomly allocated to group cognitive-behavioural therapy (CBT) plus taper, or group support (GS) plus taper. At 3 months follow-up, the outcomes in both the CBT and the GS subgroups were equivalent. Intention to treat analysis revealed a slight advantage to the CBT over the G S group and the CBT group showed higher self-efficacy post-taper. Over all 86 participants, a high-baseline level of psychological distress, anxiety and dosage predicted a poor outcome, but increase in self-efficacy contributed to a successful outcome particularly in those with initially poor baseline predictors. Although there was a decrease in positive affect during preliminary stages of tapered discontinuation compared to baseline, there was no significant overall increase in negative affect. Copyright (C) 2008 John Wiley & Sons, Ltd.