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Individualized rTMS Treatment for Depression using an fMRI-Based Targeting Method

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Published on: August 2, 2021

Costo y resultado de la activación conductual frente a la terapia cognitivo-conductual para la depresión (COBRA): un

David A Richards¹, David Ekers², Dean McMillan³

¹Medical School, University of Exeter, Exeter, UK.

Lancet (London, England)

|July 28, 2016

Resumen

La activación conductual (BA) es tan efectiva como la terapia cognitivo-conductual (TCC) para la depresión. Esta terapia más simple puede ser administrada por trabajadores de salud mental menos especializados, ofreciendo una opción de tratamiento rentable.

Área de la Ciencia:

La psiquiatría
Psicología clínica
Economía de la salud

Sus antecedentes:

La depresión es un trastorno de salud mental frecuente y costoso.
La terapia cognitivo-conductual (TCC) es eficaz pero compleja y costosa.
La activación conductual (BA) ofrece una alternativa más simple y potencialmente más rentable.

Objetivo del estudio:

Comparar la eficacia clínica y la relación costo-efectividad de la AAC frente a la TCC en adultos con depresión.
Para determinar si la ABA no es inferior a la TCC en el tratamiento de los síntomas depresivos.

Principales métodos:

Un ensayo aleatorizado, controlado, de no inferioridad que involucra a adultos diagnosticados con trastorno depresivo mayor.
Los participantes fueron asignados aleatoriamente para recibir BA o CBT.
Los síntomas de depresión se evaluaron utilizando el Cuestionario de Salud del Paciente 9 (PHQ-9) a los 12 meses.

Principales resultados:

Se encontró que la activación conductual (BA) no era inferior a la terapia cognitivo-conductual (TCC).
Las puntuaciones medias de PHQ-9 a los 12 meses fueron similares entre los grupos BA y CBT (8,4 frente a 8,4 en la población de intención de tratamiento modificada).
No se observaron diferencias significativas en los eventos adversos graves entre los dos grupos de tratamiento.

Conclusiones:

La activación conductual (BA) es una alternativa clínicamente efectiva y no inferior a la TCC para la depresión.
BA puede ser impartido por trabajadores de salud mental jóvenes con una formación menos intensiva, reduciendo los costos.
Esto sugiere que se puede proporcionar una terapia psicológica eficaz para la depresión sin requerir profesionales altamente especializados y costosos.

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