使用正念加监测与单独监测来支持抗抑郁药物停用:一般实践中的一个集群随机试验
Marloes J Huijbers1, Carolien Wentink1, Peter L B J Lucassen2
1Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.
PloS one
|September 5, 2023
概括
将基于正念的认知疗法 (MBCT) 添加到支持的协议断药 (SPD) 时,与单独的SPD相比,抗抑郁药断药率没有显著改善. 在一般实践环境中,患者参与这些干预措施的比例显著低.
科学领域:
- 临床心理学 临床心理学
- 一般的做法一般的做法
- 心理治疗研究 心理治疗研究
背景情况:
- 停止服用抗抑郁药物 (ADM) 对患者和临床医生来说都是一个挑战.
- 支持的协议断药 (SPD) 是一种帮助ADM戒药的策略.
- 基于正念的认知疗法 (MBCT) 可能为停用ADM提供额外的支持.
研究的目的:
- 评估是否将MBCT添加到SPD中,与单独的SPD相比,增加了ADM停药率.
- 评估MBCT在通过抗抑郁药逐渐减缓支持患者的有效性.
- 调查二次结果,包括抑郁,焦虑和戒断症状.
主要方法:
- 一个前性,集群随机对照试验,涉及荷兰的初级保健实践.
- 成年患者在ADM超过9个月被随机分配到SPD+MBCT或单独SPD.
- 干预措施包括帮助决策,个性化逐渐缩减时间表,MBCT会议或SPD咨询.
- 结果在基线和干预后6,9个月和12个月被评估.
主要成果:
- 在SPD+MBCT组 (44%) 和SPD单独组 (33%) 之间,在6个月内完全停止ADM的速度没有显著差异.
- MBCT的完成率很低,仅有27%的分配患者完成了该计划.
- 在试验期间没有报告任何严重不良事件.
结论:
- 将MBCT添加到SPD并没有显示出在一般实践环境中支持抗抑郁药物停药的显著益处.
- 实践和患者的低参与率凸显了实施此类干预措施的潜在障碍.
- 可能需要进一步的研究来优化ADM停产中MBCT的交付和参与策略.
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