Combined Cognitive-Behavioral and Pharmacological Continuation and Maintenance Treatment of Recurrent Depression

虽然复发性抑郁症是药物维持治疗的既定指标，但对于持续或维持治疗中额外的认知行为治疗的长期益处，缺乏经验支持。这项研究的主要目标是在一项多中心、对照、随机的试验中，比较认知-行为维持疗法(CBMT)加药物延续/维持疗法(如往常一样治疗，TAU)与手动心理教育(MAPE)加TAU对门诊复发抑郁症患者的长期结果。符合以下标准的患者包括：诊断为复发性抑郁障碍(≥3次主要抑郁发作)，目前正在缓解中；在急性抑郁发作急性治疗后8周以上完全缓解；在干预前12个月内至少有一次指数抑郁发作。排除标准为：器质性障碍；精神药物引起的心理/行为障碍；精神分裂症；分裂情感障碍；躁郁症；中度至严重精神发育迟滞；急性自杀；严重共病。符合纳入标准的患者被随机分配到两种情况中的一种(CBMT+TAU或MAPE+TAU)。目前，已从莱茵-美因河地区和图林根州的12家精神病院和心理部门的12家门诊招募了186名患者。目前，该试验的资金包括评估两种治疗形式对MDE在治疗后仅一年内复发/复发的影响。目前还没有对大型和控制良好的小径进行这样的长期跟踪。但在复发性抑郁症中，长期预防复发是最相关的结果标准。

While recurrent depression is an established indicator for pharmacological maintenance treatment, empirical support for the long-term benefit of additional cognitive-behavioral therapy in continuation or maintenance treatment is lacking. The major goal of the study is to compare the long-term outcome of cognitive-behavioural maintenance therapy (CBMT) plus pharmacological continuation/maintenance treatment (treatment as usual, TAU) versus manualized psychoeducation (MAPE) plus TAU for out-patients with recurrent depression in a multi-centre, controlled, randomised trial. Patients meeting the following criteria were included: diagnosis of recurrent depressive disorder (≥ 3 major depressive episodes, MDE), currently in remission; complete remission over 8 weeks after acute treatment of MDE; at least one index depressive episode in the 12 months prior to the intervention. Exclusion criteria were: organic disorder; psychological / behavioural disorders caused by psychotropic substances; schizophrenia; schizoaffective disorder; bipolar depression; moderate to severe mental retardation; acute suicidality; severe comorbid medical condition. Patients meeting the inclusion criteria were randomly assigned to one of the two conditions (CBMT plus TAU or MAPE plus TAU). Currently, 186 patients have been recruited from 12 outpatient clinics of psychiatric hospitals and psychological departments in the Rhine-Main region and Thuringia. Funding of the trial presently covers an assessment of the effects of both treatment forms on the occurrence of relapse/recurrence of MDE for a period of only one year following treatment. There are no such long-term follow-ups of large and well controlled trails available. But in recurrent depression long-term relapse prevention is the most relevant outcome criteria.