A Novel Therapy for Depression with Co-Occurring Panic

描述：恐慌症伴发的重度抑郁症 发作或恐慌症既常见又临床意义重大。病人 这种情况表现出更严重的症状特征，更大的风险 自杀倾向、较差的心理社会功能和较差的对 传统的抑郁症治疗方法。当前提案的主要目的是 开发一种有效而有效的心理治疗干预方法 伴有惊恐症状的重度抑郁症患者。这是一项新的 有恐慌症的抑郁症的人际心理治疗(I PT-PS)，将适应和整合认知行为疗法(CBT)的组成部分 对于恐慌和焦虑(Barlow&Craske，1989)的治疗框架 抑郁症的人际心理治疗(IPT，Kierman等人，1984) 这种临床上严重但对治疗有抗药性的情况。从概念上讲，这 综合治疗方法将寻求促进积极解决 人际关系问题，同时处理恐慌症状和 干扰积极解决人际问题的焦虑。在第I阶段， 这项拟议的研究对12名重度抑郁症合并恐慌的患者进行了调查 症状将通过新开发的16节疗程进行治疗 治疗。第一阶段的具体目标包括开发、细化和 迭代完善IPT-PS治疗手册；开发治疗师 培训程序；制定治疗依从性措施； 能力和满足感。在第二阶段，24名抑郁症患者 并发恐慌症状的患者将被随机分配到使用 IPT-PS，并将与随机分配的12名患者进行比较 标准IPT。这项试验性研究的具体目标包括：最后确定 治疗手册和治疗依从性、能力和措施 满意度；使用IPT-PS测试治疗满意度；评估 治疗应答者和无应答者的特征；以及 治疗效果大小估计用于规划更大的 IPT-PS的疗效/疗效研究。

DESCRIPTION: Complication of major depression by the co-occurrence of panic attacks or panic disorder is both common and clinically significant. Patients with this condition show more severe symptom profiles, greater risk of suicidality, poorer psychosocial functioning, and a poorer response to traditional depression treatments. The primary aim of the current proposal is to develop an effective yet efficient psychotherapeutic intervention for patients with major depression complicated by panic symptoms. This new treatment, interpersonal psychotherapy for depression with panic symptoms (I PT-PS), will adapt and integrate components of cognitive behavior therapy (CBT) for panic and anxiety (Barlow & Craske, 1989) into the therapeutic framework of interpersonal psychotherapy for depression (IPT, Kierman et al., 1984) to treat this clinically severe yet treatment-resistant condition. Conceptually, this integrated treatment approach will seek to promote active resolution of interpersonal problems while concurrently addressing symptoms of panic and anxiety that interfere with active interpersonal problem solving. In Phase I of the proposed study, 12 patients with major depression complicated by panic symptoms will be treated with a 16-session course of the newly developed treatment. Specific aims of Phase I include the development, elaboration, and iterative refinement of a treatment manual for IPT-PS; development of therapist training procedures; and the development of measures of treatment adherence, competence, and satisfaction. In Phase II, 24 patients with depression complicated by panic symptoms will be randomly assigned to treatment using IPT-PS, and will be compared with 12 patients randomly assigned to receive standard IPT. Specific aims of this pilot study include: finalizing the treatment manual and measures of treatment adherence, competence, and satisfaction; testing treatment satisfaction with IPT-PS; evaluating characteristics of treatment responders and non-responders; and generating treatment effect size estimates for use in planning a larger efficacy/effectiveness study of IPT-PS.