对比CBT和低频rTMS在减少症状严重性和抑郁症以及改善强迫症成年人的工作记忆方面的有效性:一项临床试验
Arash Fazeli1, Ahmad Zolghadriha2, Reza Pirzeh2
1Department of Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
The International journal of neuroscience
|November 8, 2023
概括
暴露和响应预防的认知行为疗法 (CBT与ERP) 比低频重复性横磁性刺激 (LF-rTMS) 更有效地减少强迫症 (OCD) 症状和抑郁症. 两种治疗都没有显著改善工作记忆.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
背景情况:
- 强迫症 (OCD) 是一种使人虚弱的心理健康状况,其特点是侵入性思想和重复性行为.
- 目前对强迫症的治疗包括药物治疗,心理治疗和神经调节技术,每一种疗效和副作用的概况各不相同.
- 认知行为疗法 (CBT),特别是暴露和反应预防 (ERP),是强迫症的第一线治疗方法,而重复性跨磁刺激 (rTMS) 是一种新兴的治疗选择.
研究的目的:
- 为了比较CBT与ERP与LF-rTMS在减少强迫症症状严重程度和抑郁症状方面的疗效.
- 评估这两种干预措施对强迫症成年人工作记忆的影响.
- 为了确定这些治疗在一个月的随访期间的长期有效性.
主要方法:
- 一项随机临床试验,涉及24名被诊断患有强迫症的成年人.
- 参与者被分配到CBT与ERP (n=12,20次) 或LF-rTMS (n=12,10次) 中,目标是右背侧前额叶皮层.
- 症状严重程度,抑郁症和工作记忆被评估使用耶鲁-布朗强迫症强迫性尺度,汉密尔顿抑郁症评分尺度和N-Back任务,分别在基线,干预后立即和一个月后.
主要成果:
- 与LF-rTMS相比,干预后立即,CBT与ERP显著减少了强迫症症状严重程度 (p <0.05) 和抑郁症 (p = 0.002).
- 在改善工作记忆方面,两组之间没有发现显著差异 (p > 0.05).
- 在一个月的随访中,对于任何被评估的变量,没有发现两组之间的显著差异.
结论:
- 个人CBT与ERP是一种比LF-rTMS更有效的治疗方法,可以减少强迫症患者的急性症状和抑郁症.
- 无论是ERP或LF-rTMS的CBT都没有在改善该患者群体的工作记忆方面显著的优势.
- 在强迫症症状和抑郁症减少方面,CBT与ERP相比LF-rTMS的优势在一个月的随访中没有持续.
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