Clarke G N, Rohde P, Lewinsohn P M, Hops H, Seeley J R
Kaiser Permanente Center for Health Research, Portland, OR 97227-1098, USA.
J Am Acad Child Adolesc Psychiatry. 1999 Mar;38(3):272-9. doi: 10.1097/00004583-199903000-00014.
This trial examined the effects of both acute and maintenance cognitive-behavioral therapy (CBT) for depressed adolescents.
Adolescents with major depression or dysthymia (N = 123) were randomly assigned to 1 of 3 eight-week acute conditions: adolescent group CBT (16 two-hour sessions); adolescent group CBT with a separate parent group; or waitlist control. Subsequently, participants completing the acute CBT groups were randomly reassigned to 1 of 3 conditions for the 24-month follow-up period: assessments every 4 months with booster sessions; assessments only every 4 months; or assessments only every 12 months.
Acute CBT groups yielded higher depression recovery rates (66.7%) than the waitlist (48.1%), and greater reduction in self-reported depression. Outcomes for the adolescent-only and adolescent + parent conditions were not significantly different. Rates of recurrence during the 2-year follow-up were lower than found with treated adult depression. The booster sessions did not reduce the rate of recurrence in the follow-up period but appeared to accelerate recovery among participants who were still depressed at the end of the acute phase.
The findings, which replicate and expand upon a previous study, support the growing evidence that CBT is an effective intervention for adolescent depression.
本试验研究了急性和维持性认知行为疗法（CBT）对抑郁青少年的影响。
123名患有重度抑郁症或心境恶劣的青少年被随机分配到3种为期8周的急性治疗方案中的一种：青少年组CBT（16次两小时疗程）；青少年组CBT并伴有单独的家长组；或等待名单对照组。随后，完成急性CBT组治疗的参与者被随机重新分配到3种方案中的一种，进行为期24个月的随访：每4个月进行评估并伴有强化治疗；仅每4个月进行评估；或仅每12个月进行评估。
急性CBT组的抑郁恢复率（66.7%）高于等待名单对照组（48.1%），且自我报告的抑郁症状有更大程度的减轻。仅青少年组和青少年+家长组的治疗效果无显著差异。2年随访期间的复发率低于接受治疗的成年抑郁症患者。强化治疗并未降低随访期的复发率，但似乎加速了急性期结束时仍处于抑郁状态的参与者的康复。
这些结果重复并扩展了之前的一项研究，支持了越来越多的证据表明CBT是治疗青少年抑郁症的有效干预措施。
