Outcomes of patients completing and not completing cognitive therapy for depression
Outcomes of patients completing and not completing cognitive therapy for depression
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DOI：
10.1348/014466503321903553
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发表时间：
2003-06-01
影响因子：
3.1
通讯作者：
Macaskill, N
中科院分区：
文献类型：
--
作者：
Cahill, J;Barkham, M;Macaskill, N
目标.本研究的目的是使用在每次会话中收集的症状强度测量（1）来描述在临床代表性样本中接受认知疗法（CT）治疗抑郁症的客户的结果，以及（2）比较完成约定数量会话的客户与未完成会话的客户的结果。客户（N = 58）签约参加12和20个会议之间的CT完成贝克抑郁量表（BDI）之前，立即每个疗程。BDI和其他指标在入组时收集，对于完成治疗的患者，在治疗后评估时收集。完成者的BDI评分从开始到治疗后显著改善，从开始到最后一次治疗的改善程度显著高于未完成者。然而，当非完成者的最后一节课分数与随机选择的完成者在相应节课的分数相匹配时，改善的差异并不显著。完成约定疗程的患者中有显著较高比例的患者（71.4%，25/35）实现了可靠和临床显著的变化，而未完成约定疗程的患者中只有13%（3/23）实现了可靠和临床显著的变化。(1)抑郁症的CT可以在临床代表性人群中有效。(2)临床试验的结果可能会使治疗效果的估计产生偏差。
Objectives. The aims of this study were to use symptom intensity measures collected at each session (1) to describe the outcomes of clients who received cognitive therapy (CT) for depression in a clinically representative sample, and (2) to compare the outcomes of clients who completed the agreed number of sessions with those who did not.Design and method. Clients (N = 58) contracted to attend between 12 and 20 sessions of CT completed the Beck Depression Inventory (BDI) immediately prior to each therapy session. The BDI and other measures were collected at intake and, for those who completed therapy, at a post-therapy assessment.Results. Completers' BDI scores improved significantly from intake to post-treatment and significantly more from intake to their final session than did those of non-completers. However, when non-completers' final session scores were matched with scores of randomly selected completers at the corresponding session, the difference in improvement was not significant. A significantly higher proportion of clients who completed the agreed number of sessions achieved reliable and clinically significant change (71.4%, 25/35), compared with just 13% (3/23) of clients who did not.Conclusions. (1) CT for depression can be effective in a clinically representative population. (2) Attrition from clinical trials may bias estimates of treatment effectiveness.