Telephone Versus Face-to-Face Administration of CBT for Depression

电话与面对面治疗抑郁症的 CBT 管理

• 批准号: 7663752
• 负责人: DAVID CURTIS MOHR
• 金额: $ 103.23万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-08 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7663752
• 关键词: Accounting; Advisory Committees; American Psychological Association; Antidepressive Agents; Appointments and Schedules; Behavioral; Caring; Client satisfaction; Clinical; Cognitive; Counseling; Data; Development; Disabled Persons; Drops; Education; Emotional; Emotions; Enrollment; Face; Failure; Freedom; Grant; Health; Health Personnel; Health Policy; Health Services; Health Services Accessibility; Healthcare; Home environment; Individual; Intervention; Life; Literature; Low income; Major Depressive Disorder; Measures; Mediating; Mediator of activation protein; Mental Health; Meta-Analysis; Modeling; Motivation; Multiple Sclerosis; National Institute of Mental Health; Outcome; Outcome Measure; Patients; Pharmaceutical Preparations; Pharmacotherapy; Phase; Population; Prevalence; Primary Health Care; Provider; Psychotherapy; Relative (related person); Reporting; Research; Research Personnel; Sampling; Services; Site; Societies; Specialist; Specific qualifier value; Stigmata; Telephone; Testing; Therapeutic; Time; Transportation; Treatment outcome; United States; Upper arm; Veterans; Western World; Work; caregiving; cognitive behavior therapy; comparative efficacy; cost; demographics; depressed; depression; design; disability; effective therapy; experience; follow-up; functional disability; health administration; preference; programs; psychosocial; residence; rural area; satisfaction; social stigma

DESCRIPTION (provided by applicant): Major depressive disorder (MOD) is common, with 12-month prevalence rates estimated at between 6.6- 10.3%. A large literature has established that depression can be effectively treated using pharmacotherapy and/or psychotherapy. Several studies have found that given a choice, about two-thirds of depressed patients prefer psychotherapy or counseling over antidepressant medication. While psychotherapy is both effective and ostensibly desirable, a variety of barriers exist both to initiating and maintaining psychotherapy. Only about 20% of all patients referred for psychotherapy ever follow-up. Of those who do initiate psychotherapy, nearly half drop out prior to completion of treatment. Administering psychotherapy over the telephone may overcome many barriers associated with failure to initiate treatment and attrition from treatment. A number of recent studies have shown that telephone- administered treatments are effective at reducing depression, well accepted by patients, able to extend treatment to patients who experience significant barriers including disabilities. Furthermore, telephone administered psychotherapies are likely associated with low rates of attrition, compared to treatments delivered face-to-face. This study will compare a 16-week telephone-administered cognitive behavioral therapy (T-CBT) intervention to 16 weeks of face-to-face CBT (FtF-CBT). It is hypothesized that 1)T-CBT will produce lower rates of attrition compared to FtF-CBT, 2) intent-to-treat analyses will show T-CBT to produce significantly greater reductions in depression compared to FtF-CBT, in the sample initiating treatment and 3) the greater reductions in depression associated with T-CBT will be fully mediated by attrition. This research has the potential to produce a manualized T-CBT program that could extend treatment to many populations who are currently unable to access care.

描述（由申请人提供）：重度抑郁症（MOD）很常见，12个月患病率估计在6.6- 10.3%之间。大量文献已经证实，抑郁症可以通过药物治疗和/或心理治疗有效治疗。一些研究发现，如果可以选择，大约三分之二的抑郁症患者更喜欢心理治疗或咨询，而不是抗抑郁药物。虽然心理治疗是有效的，表面上是可取的，各种障碍都存在启动和维持心理治疗。只有约20%的患者转介心理治疗的后续行动。在那些开始心理治疗的人中，近一半在完成治疗之前退出。通过电话进行心理治疗可以克服许多与未能启动治疗和治疗损耗相关的障碍。最近的一些研究表明，电话管理的治疗在减少抑郁症方面是有效的，被患者很好地接受，能够将治疗扩展到经历显著障碍（包括残疾）的患者。此外，与面对面的治疗相比，电话管理的心理治疗可能与低流失率相关。这项研究将比较16周的电话管理认知行为疗法（T-CBT）干预与16周的面对面CBT（FtF-CBT）。假设1）与FtF-CBT相比，T-CBT将产生较低的损耗率，2）意向治疗分析将显示，在开始治疗的样本中，与FtF-CBT相比，T-CBT产生显著更大的抑郁减少，3）与T-CBT相关的抑郁减少更大，完全由损耗介导。这项研究有可能产生一个手动的T-CBT计划，可以将治疗扩展到许多目前无法获得护理的人群。