心理治疗与抗抑郁药对心力衰竭抑郁症的比较有效性:一项随机临床试验
Waguih William IsHak1,2, Michele A Hamilton3, Samuel Korouri1
1Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California.
JAMA network open
|January 17, 2024
概括
行为激活 (BA) 和抗抑郁药物管理 (MEDS) 同样降低了心力衰竭 (HF) 患者的抑郁症. BA改善了身体生活质量,减少了住院和急诊的次数.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 相对有效性研究研究比较
背景情况:
- 心力衰竭 (HF) 影响全球数以百万计的人,伴随性抑郁症的患病率很高.
- 对HF患者有效的抑郁症治疗策略尚不清楚,需要进行比较研究.
研究的目的:
- 为了比较行为激活心理治疗 (BA) 与抗抑郁药物管理 (MEDS) 的有效性,在患有HF和抑郁症的患者中以患者为中心的结果.
主要方法:
- 一项实用随机比较有效性试验,涉及416名患有高血压和抑郁症的患者.
- 患者被随机分配到接受BA或MEDS,结果在12个月内进行评估.
- 主要结局:抑郁症状严重程度 (PHQ-9);次要结局:生活质量 (SF-12,KCQ),照顾者负担,医疗利用率和死亡率.
主要成果:
- 在12个月后,BA和MEDS都显著减少了大约50%的抑郁症状,在两组之间没有显著的差异 (P=.55).
- 接受BA的患者在身体生活质量方面呈现出统计学上显著的改善 (P=.04).
- 与MEDS相比,BA与更少的急诊室访问 (P=.001) 和更少的住院日 (P=.001) 相关.
结论:
- 行为激活和药物管理在减少心力衰竭患者抑郁症状方面同样有效.
- 行为激活可能提供额外的好处,包括改善身体生活质量和减少医疗保健利用.
- 患有心力衰竭和抑郁症的患者可以在BA或MEDS之间进行选择,以管理他们的抑郁症.
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