Psychosocial Treatment for Atypical Depression

非典型抑郁症的心理社会治疗

• 批准号: 7109544
• 负责人: LAUREN M WEINSTOCK
• 金额: $ 5.04万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7109544
• 关键词: clinical research; postdoctoral investigator

DESCRIPTION (provided by applicant): Psychosocial interventions for atypical depression (AD) have been relatively ignored in the clinical research literature, despite evidence to suggest that AD is marked by earlier age of disorder onset, greater length of index episode, greater symptom severity, poorer response to certain classes of antidepressants, and increased risk for relapse and recurrence. Moreover, those with AD are at greater risk for a comorbid anxiety disorder as well as impairment in social functioning, both of which have been identified as poor prognostic indicators for course of major depression. Although there is preliminary evidence to suggest that individuals with AD respond to standard CBT for depression, a substantial percentage of patients remain treatment non-responders. Thus, improvements in treatments targeted toward AD are clearly warranted. This application proposes the development of a tailored psychosocial intervention for AD, based upon principles of behavioral activation for major depression and cognitive-behavioral group therapy for social anxiety. This work will consist of 3 phases: 1) A development phase focused on intervention conceptualization and design, 2) An initial pilot phase to conduct a preliminary treatment revision, and 3) An open trial phase in order to fully pilot the intervention, examine feasibility and acceptability, and to establish a preliminary pre- to post-treatment effect size for future treatment development. We propose to recruit 40 individuals with DSM-IV MDD with atypical features for the proposed treatment development study.

描述（由申请人提供）：尽管有证据表明AD的特征是疾病发作年龄较早、指数发作时间较长、症状严重程度较高、对某些类别的抗抑郁药的反应较差以及复发和复发风险增加，但在临床研究文献中，非典型抑郁症（AD）的心理社会干预相对被忽视。此外，AD患者患共病焦虑障碍和社会功能障碍的风险更大，这两者都被确定为重度抑郁症病程的不良预后指标。虽然有初步证据表明AD患者对标准CBT治疗抑郁症有反应，但仍有相当比例的患者对治疗无反应。因此，针对AD的治疗的改进显然是必要的。本申请提出了一个定制的心理社会干预AD的发展，基于行为激活的原则，抑郁症和认知行为团体治疗社交焦虑。这项工作将包括3个阶段：1）开发阶段，重点是干预概念化和设计; 2）初始试验阶段，进行初步治疗修订; 3）开放试验阶段，以全面试验干预，检查可行性和可接受性，并为未来的治疗开发建立初步的治疗前至治疗后效应量。我们建议招募40名患有DSM-IV MDD且具有非典型特征的个体用于拟定的治疗开发研究。