MAINTENANCE PSYCHOTHERAPY IN RECURRENT DEPRESSION

尽管有几种形式的治疗方法在改善 长期反复抑郁症病程，更好地了解 心理治疗的预防能力似乎对 被赋予抑郁症心理社会易感性因素的女性 对女性的观察和抗抑郁药物的不良影响 整个生育年限内的维持治疗。我们最近 对复发性抑郁症的维持疗法的完成研究表明 人际心理治疗作为维持性治疗的可能效用 战略，特别是在妇女方面。这项建议的具体目的是 扩大我们对预防性维护能力的了解 女性人际心理治疗(IPT-M)。为了确定 IPT-M的“剂量”是否高于我们最近试验中使用的剂量 进一步延长生存时间和防止复发，抑郁症妇女在ACT 至少他们的单相抑郁的第二个离散发作将是 分配到三个水平的IPT-M之一(高剂量=每周；中剂量 =每两周；低剂量=每月)。每周急性发作和持续发作后 治疗，受试者将被随机分配到三个IPT-M之一 频率。我们假设IPT-M频率的增加将是 与更长的重复时间和更少的 症状加重不符合新发作的标准。我们 进一步假设，有三个变量可能会缓和这一趋势 效果：1)睡眠增量比低的女性(增量波数 在第一个NREM周期中除以 第二个NREM期)将显示较短的复发时间；2)有 生活事件越严重，复发的时间越短；3)女性 在被评为IPT特异性较低的患者/治疗师二人组中将显示 更短的复发时间。通过将我们的调查局限于这些女性 对于对急性IPT有反应的复发性抑郁症，我们希望关注 最有可能寻求并受益于非药物的人群 维护策略。

Although several forms of treatment have shown promise in ameliorating the long-term course of recurrent depression, a better understanding of the preventative capacity of psychotherapy seems particularly critical for women given the many psychosocial vulnerability factors for depression observed in women and the adverse implications of antidepressant maintenance treatment throughout the childbearing years. Our recently completed study of Maintenance Therapies in Recurrent Depression points to the possible utility of interpersonal psychotherapy as a maintenance strategy, particularly in women. The specific aim of this proposal is to expand our knowledge regarding the prophylactic capacity of maintenance interpersonal psychotherapy (IPT-M) in women. In order to determine whether a higher "dose" of IPT-M than was employed in our recent trial can further extend survival time and prevent recurrence, depressed women in at least their second discrete episode of unipolar depression, will be assigned to one of three levels of IPT-M (high dose = weekly; medium dose = biweekly; low dose = monthly). After weekly acute and continuation treatment, subjects will be randomly assigned to one of the three IPT-M frequencies. We hypothesize that increased frequency of IPT-M will be associated with longer time to recurrence, and fewer instances of symptomatic exacerbation not meeting criteria for a new episode. We further hypothesize that, three variables are likely to moderate this effect: 1) women with low delta sleep ratio (number of delta wave counts in the first NREM period divided by number of delta wave counts in the second NREM period) will show shorter time to recurrence; 2) women with more severe life events will show shorter time to recurrence; and 3) women in patient/therapist dyads rated as low on specificity of IPT will show shorter time to recurrence. By limiting our investigation to those women with recurrent depression who respond to acute IPT, we hope to focus on the population most likely to seek and benefit from non-pharmacologic maintenance strategies.