合并性失眠和抑郁症的心理治疗:一项双盲随机的安慰剂受控试验
Kerstin Blom1, Erik Forsell1, Monica Hellberg2
1Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Psychotherapy and psychosomatics
|January 29, 2024
概括
失眠的认知行为疗法 (CBT-I) 有效治疗失眠,但在与治疗抑郁症的CBT相结合时,不会改善并发性抑郁症. 对于患有这两种疾病的患者,建议单独使用CBT-I.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 行为科学 行为科学
背景情况:
- 失眠和抑郁症经常同时发生,影响患者的幸福感.
- 失眠的认知行为疗法 (CBT-I) 对失眠和并发性抑郁症有效,但其对抑郁症的具体影响仍在争论中.
- 目前的治疗可能会留下残留的抑郁症状,需要改进治疗方法.
研究的目的:
- 调查结合CBT-I与认知行为疗法 (CBT) 治疗抑郁症是否可以改善这两种情况的结果.
- 为了比较结合CBT-I和CBT治疗抑郁症的治疗与CBT治疗抑郁症的治疗与安慰剂失眠干预.
- 为了确定是否将CBT-I添加到抑郁症的CBT中,而不增加治疗时间,可以获得更好的结果.
主要方法:
- 一个为期12周的双盲随机对照试验在精神病学环境中进行.
- 参与者 (N=126) 接受了治疗师指导的,通过互联网提供的治疗,用于诊断失眠障碍和严重抑郁症.
- 测量的主要结果是失眠严重程度 (失眠严重程度指数 - ISI) 和抑郁症状 (蒙特哥马利-阿斯伯格抑郁评分表 - MADRS-S).
主要成果:
- 与对照组相比,联合治疗对减少失眠严重程度产生了特定的,显著的效果 (p = 0.007).
- 在联合治疗和对照组之间没有观察到抑郁症严重性减少的显著差异.
- 这两种治疗都在治疗后和6个月的随访中显著改善了抑郁症症状,在治疗后和6个月的随访中观察到大的效果大小 (科恩的d).
结论:
- 在伴随抑郁症的患者中,CBT-I对失眠严重程度有显著的,具体的益处.
- 结合CBT-I与CBT治疗抑郁症,与单独治疗抑郁症的CBT相比,CBT对抑郁症症状没有额外的益处.
- 建议CBT-I作为伴随性抑郁症失眠的首要治疗方法,联合治疗可能会过于繁重而没有额外的好处.
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