行動活性化対認知行動療法 (COBRA) の費用と結果: ランダム化され,コントロールされ,劣等性のない試験
David A Richards1, David Ekers2, Dean McMillan3
1Medical School, University of Exeter, Exeter, UK.
Lancet (London, England)
|July 28, 2016
まとめ
行動活性化 (BA) は 認知行動療法 (CBT) と同じくらい効果的です このシンプルな治療法は 専門知識の少ない精神保健医療従事者によって 提供され 費用対効果の高い治療法となります
科学分野:
- 精神科
- 臨床心理学
- 健康 経済
背景:
- うつ病は広範囲に広がり 高い費用がかかる 精神疾患です
- 認知行動療法 (CBT) は効果的ですが 複雑で高価です
- 行動活性化 (BA) はよりシンプルで潜在的に費用対効果の高い代替手段です
研究 の 目的:
- 鬱病の成人のBA対CBTの臨床効果と費用対効果を比較する.
- 抑うつ症状の治療において,BAがCBTに劣らないかどうかを判断する.
主な方法:
- 重度のうつ病と診断された成人を対象とした ランダム化され,制御された,劣等性のない試験です.
- 参加者はランダムに BAまたはCBTのいずれかを割り当てられました.
- 鬱病の症状は,患者健康アンケート9 (PHQ-9) を用いて12ヶ月で評価された.
主要な成果:
- 行動活性化 (BA) は認知行動療法 (CBT) に劣らないことが判明しました.
- 12ヶ月の平均PHQ-9スコアは,BA群とCBT群の間で類似していた (修正された治療意図群では8. 4対8. 4).
- 2つの治療群の間で重大な有害事象の有意な違いは観察されなかった.
結論:
- 行動活性化 (BA) は,うつ病に対するCBTの臨床的に有効で劣らない代替手段です.
- BAは若手精神保健医療従事者によって 提供され 訓練の強さが低く 費用が削減されます
- これは うつ病に対する 効果的な心理療法が 高度な専門知識と費用のかかる専門家の 必要なしに 提供できることを示唆しています
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