对强迫症患者进行深度大脑刺激的认知行为疗法:一项匹配的受控研究
Ilse Graat1, Sophie Franken1, Geeske van Rooijen1
1Amsterdam UMC Locatie AMC, Amsterdam, Netherlands.
Psychological medicine
|October 5, 2023
概括
认知行为疗法 (CBT) 对强迫症 (OCD) 的深度大脑刺激 (DBS) 没有显著增加. 症状改善发生在不考虑术后CBT的情况下,这表明DBS的影响可能是独立的.
科学领域:
- 神经外科 神经外科
- 精神病学是一个精神病学.
- 认知行为疗法是认知行为疗法.
背景情况:
- 深度大脑刺激 (DBS) 是一种已被公认的对抗强迫症 (OCD) 的治疗方法.
- 术后认知行为治疗 (CBT) 在改善强迫症的DBS结果中的作用尚不清楚,之前的研究结果相矛盾.
- 这项研究旨在澄清CBT是否增加了强迫症患者DBS的治疗效果.
研究的目的:
- 评估术后认知行为疗法 (CBT) 在强迫性强迫症 (OCD) 患者的深度大脑刺激 (DBS) 增强方面的疗效.
- 为了比较强迫症患者的治疗结果,这些患者接受了带有或没有辅助CBT的DBS.
主要方法:
- 对接受DBS治疗强迫症患者的回顾性分析,比较那些有和没有术后CBT的患者.
- 评估耶鲁-布朗强迫症-强迫症量表 (Y-BOCS) 和汉密尔顿抑郁症评分表 (HAM-D) 的分数.
- 匹配对分析比较CBT和无CBT组之间的结果,控制基线变量和初始DBS反应.
主要成果:
- 在接受CBT的患者中,Y-BOCS得分显示统计学上显著下降 (14.8%,p=0.043),而HAM-D得分则没有.
- 对10名接受CBT和10名没有接受CBT的患者进行匹配分析,显示在相似时间段内Y-BOCS得分下降没有显著差异 (10%对13.1%,p=0.741).
- 在这两组中,强迫症症状随着时间的推移而有所改善,无论CBT是否被给予.
结论:
- 在患有和没有术后CBT的患者中,强迫症症状有所改善,这表明DBS本身的晚效效应.
- 该研究没有发现证据表明CBT显著增加了强迫症的DBS结果.
- 通过前性随机对照试验进行进一步的研究是有必要的,以最终评估CBT对强迫症的DBS疗效的影响.
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