一个随机对照试验测试了连续心理治疗对抑郁症的影响:改变治疗师,还是治疗师和方法?
Maartje Miggiels1, Peter Ten Klooster2, Aartjan Beekman3
1Dimence Group, PO Box 5003, 7400 CG, Deventer, the Netherlands; Department of Psychiatry, Amsterdam UMC, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
Journal of affective disorders
|November 24, 2025
概括
对于患有重度抑郁症的成年人来说,在最初没有反应后继续接受心理治疗,可以获得适度的症状改善. 改变治疗师或治疗方法并没有提供额外的好处,但也没有损害结果.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 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:
- 对患有严重抑郁症 (MDD) 的成年人进行研究的顺序性心理治疗对初始治疗没有反应.
- 专注于那些没有响应认知行为疗法 (CBT) 或短期精神动力学支持性心理治疗 (SPSP) 的患者.
研究的目的:
- 评估不同顺序心理治疗策略对非响应者的有效性.
- 为了确定转换治疗师或治疗方法是否会改善结果,而不是继续使用相同的方法.
主要方法:
- 随机对照试验涉及荷兰163名MDD非响应者.
- 参与者被分配到:继续与相同的治疗师,切换治疗师,或切换治疗师和治疗方法.
- 所有人都接受了额外的16次会议;使用抑郁症症状库存 - 自我报告 (IDS-SR) 来测量抑郁症症状严重程度.
主要成果:
- 所有组都显示治疗后抑郁症状的适度,统计显著减少.
- 在这三种策略中,没有观察到症状减少,反应率或缓解率的显著差异.
- 抑郁症状的平均变化为 -5.23 (科恩的d = 0.29).
结论:
- 在最初没有反应后继续心理治疗会导致MDD中适度的症状改善.
- 改变治疗师或治疗方法不会比继续治疗提供额外的好处.
- 结果表明需要个性化方法,因为没有一个单一的切换策略适合所有非响应者.
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