Mufson L, Weissman M M, Moreau D, Garfinkel R
Division of Clinical-Genetic Epidemiology, New York State Psychiatric Institute and College of Physicians and Surgeons, Columbia University, New York 10032, USA.
Arch Gen Psychiatry. 1999 Jun;56(6):573-9. doi: 10.1001/archpsyc.56.6.573.
Psychotherapy is widely used for depressed adolescents, but evidence supporting its efficacy is sparse.
In a controlled, 12-week, clinical trial of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), 48 clinic-referred adolescents (aged 12-18 years) who met the criteria for DSM-III-R major depressive disorder were randomly assigned to either weekly IPT-A or clinical monitoring. Patients were seen biweekly by a "blind" independent evaluator to assess their symptoms, social functioning, and social problem-solving skills. Thirty-two of the 48 patients completed the protocol (21 IPT-A-assigned patients and 11 patients in the control group).
Patients who received IPT-A reported a notably greater decrease in depressive symptoms and greater improvement in overall social functioning, functioning with friends, and specific problem-solving skills. In the intent-to-treat sample, 18 (75%) of 24 patients who received IPT-A compared with 11 patients (46%) in the control condition met recovery criterion (Hamilton Rating Scale for Depression score < or =6) at week 12.
These preliminary findings support the feasibility, acceptability, and efficacy of 12 weeks of IPT-A in acutely depressed adolescents in reducing depressive symptoms and improving social functioning and interpersonal problem-solving skills. Because it is a small sample consisting largely of Latino, low socioeconomic status adolescents, further studies must be conducted with other adolescent populations to confirm the generalizability of the findings.
心理治疗广泛应用于抑郁青少年,但支持其疗效的证据稀少。
在一项针对抑郁青少年的人际心理治疗(IPT - A)的对照、为期12周的临床试验中,48名符合DSM - III - R重度抑郁症标准的临床转诊青少年(年龄12 - 18岁)被随机分配至每周接受IPT - A治疗或临床监测。患者每两周由一名“盲法”独立评估者进行检查,以评估其症状、社会功能和社会问题解决能力。48名患者中有32名完成了试验方案(21名被分配接受IPT - A治疗的患者和11名对照组患者)。
接受IPT - A治疗的患者报告称,抑郁症状显著减轻,整体社会功能、与朋友相处的功能以及特定问题解决能力有更大改善。在意向性治疗样本中,接受IPT - A治疗的24名患者中有18名(75%)在第12周达到康复标准(汉密尔顿抑郁量表评分≤6),而对照组为11名患者(46%)。
这些初步研究结果支持了为期12周的IPT - A治疗对于急性抑郁青少年在减轻抑郁症状、改善社会功能和人际问题解决能力方面的可行性、可接受性和疗效。由于这是一个主要由拉丁裔、社会经济地位较低的青少年组成的小样本,必须对其他青少年群体进行进一步研究以证实这些发现的普遍性。