A Novel Therapy for Depression with Co-Occurring Panic

描述：由恐慌共同发生的重度抑郁症并发症 惊恐发作或恐慌症是常见的，并且具有临床意义。患者 这种情况下表现出更严重的症状， 自杀倾向，心理社会功能较差，对 传统的抑郁症治疗。目前提案的主要目的是 开发一种有效而高效的心理治疗干预， 伴有惊恐症状的重度抑郁症患者。这个新 抑郁症伴恐慌症状的治疗、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 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）治疗 这种临床上严重但难以治疗的疾病从概念上讲，这 综合治疗方法将寻求促进积极解决 人际关系问题，同时解决恐慌症状， 焦虑会干扰积极的人际问题解决。一阶段 这项拟议中的研究，12名抑郁症患者并发恐慌 症状将与16个疗程的新开发的 治疗第一阶段的具体目标包括开发、拟订和 反复完善IPT-PS治疗手册;治疗师的发展 培训程序;以及制定治疗依从性措施， 能力和满意度。在第二阶段，24名抑郁症患者 并发惊恐症状的患者将被随机分配到使用 IPT-PS，并将与12名随机分配接受 标准IPT。这项试点研究的具体目标包括： 治疗手册和治疗依从性、能力和 满意度; IPT-PS治疗满意度测试;评价 治疗应答者和非应答者的特征;以及 治疗效应量估计用于计划更大的 IPT-PS的疗效/有效性研究。

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.