辅助心理治疗以预防双极性障碍复发:一项随机临床试验
1Department of Psychology, Clinical Psychology and Psychotherapy, Eberhard Karls University Tuebingen, Tuebingen, Germany.
JAMA psychiatry
|June 5, 2024
概括
以技能为导向的认知行为疗法 (SEKT) 和以情感为中心的治疗 (FEST) 在预防双相情感障碍复发方面表现出同等的有效性. 然而,患有双相II型情绪障碍的患者的复发率较高,特别是SEKT.
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
- 心理治疗研究 心理治疗研究
背景情况:
- 药物治疗是双相情感障碍 (BD) 的标准,但心理治疗辅助需要进行比较有效性研究.
- 对于预防BD复发的不同心理治疗方案的比较有效性知之甚少.
研究的目的:
- 为了比较以技能为导向的,基于材料的认知行为疗法 (SEKT) 和以支持为中心的,以患者为中心的,以情感为中心的治疗 (FEST) 在预防双相情感障碍患者复发的有效性.
- 确定影响不同心理治疗患者复发率的因素.
主要方法:
- 一项为期18个月的观察者盲目随机临床试验,涉及305名患有euthymic BD (1或2型) 的患者.
- 参与者除了标准的精神病治疗和情绪稳定药物外,还接受了SEKT或FEST.
- 用结构化访谈和临床医生/自我评价来评估复发;使用生存分析 (卡普兰-梅尔,考克斯回归).
主要成果:
- 在预防新的情感发作方面,SEKT和FEST都同样有效 (SEKT:49%的复发;FEST:46%的复发).
- 双极II障碍,并发症和会议出席率预测了复发.
- 患有BD II的患者的复发率更高 (61%),特别是接受SEKT治疗时 (70%).
结论:
- 在SEKT和FEST的强化小组格式中,在预防双相情感障碍复发方面表现出相似的有效性.
- 基线因素,特别是双相情感障碍的诊断,显著影响治疗结果.
- 进一步的研究应该探索针对特定BD亚型的定制干预措施.
相关概念视频
01:30Electroconvulsive Therapy
33
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
33
01:11Blinding
2.4K
Blinding is a commonly used method of not telling participants which treatment a subject is receiving. Blinding is a critical part of a randomized control trial or RCT. It reduces the bias that affects the results. In an RCT, blinding is used in the form of a placebo. A placebo effect occurs when untreated subjects falsely believe they have received the treatment and report improved symptoms. A placebo or a dummy treatment is administered to subjects to negate the bias caused by such an effect.
2.4K
01:24Operant Conditioning Intervention
56
Operant conditioning serves as a foundational principle in therapeutic interventions aimed at modifying maladaptive behaviors. Central to this approach is the notion that behaviors, both adaptive and maladaptive, are learned through reinforcement. By analyzing the environmental factors that reinforce problematic behaviors, clinicians can design interventions to weaken these reinforcements and replace maladaptive behaviors with healthier alternatives.
In operant conditioning, behaviors that are...
In operant conditioning, behaviors that are...
56
01:25Interpersonal Psychotherapy
26
Interpersonal psychotherapy (IPT) is a structured, time-limited therapeutic approach initially developed to treat depression. It integrates key concepts from psychodynamic, humanistic, and cognitive-behavioral therapies, making it a uniquely eclectic framework. The therapy is rooted in the interpersonal theories of Adolph Meyer and Harry Stack Sullivan, as well as John Bowlby's attachment theory, and focuses on the interplay between interpersonal relationships and emotional well-being.
26
01:23Antidepressant Drugs: MAOIs and Other Agents
220
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
220
01:24Treatment Strategies for Psychological Disorders
111
Treatment approaches for psychological disorders fall into three main categories: psychological, biological, and sociocultural. Each approach targets different aspects of mental health, requiring varying levels of education and training.
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
111