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常规实践中针对轻度抑郁症的认知行为疗法的疗效

Outcome of cognitive behaviour therapy for minor depression in routine practice.

作者信息

Cuijpers Pim, Smit Filip, Voordouw Ineke, Kramer Jeannet

机构信息

Department of Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands.

出版信息

Psychol Psychother. 2005 Jun;78(Pt 2):179-88. doi: 10.1348/147608304X22391.

Abstract

OBJECTIVES

To examine (1) whether the improvement in depressive symptomatology in subjects participating in psychoeducational groups for minor depression in routine practice is comparable to the improvement realized in a randomized efficacy trial; and (2) whether the level of depressive symptoms of subjects who participated in this intervention is similar after treatment to the level of depressive symptoms of the general population.

DESIGN

Participants (N = 187) of 20 psychoeducational groups in routine practice in the Netherlands were examined before and after the intervention using the Centre for Epidemiological Studies - Depression scale (CES-D).

METHODS

The standardized improvement from pre- to post-test in subjects was compared to the improvement found in subjects participating in a randomized trial of the same intervention. Furthermore, we compared the post-test scores to the scores of the general population.

RESULTS

The improvement of depressive symptoms in routine practice was of the same magnitude as the improvement in the randomized trial. However, a considerable proportion of the participants (54.5%) still scored above the cut-off score of the CES-D at post-test, and the mean CES-D score of the participants (M = 17.0; SD = 9.8) differed significantly (p < .01) from the mean score in the general population (M = 9.7; SD = 8.6).

CONCLUSION

Psychoeducational intervention can be an important help for people with depressive symptoms. The improvement in terms of depressive symptoms in routine practice does not differ from the improvement found in a randomized trial. However, participants remained considerably more depressed than the general population and this intervention is, for many, not sufficient as a form of treatment.

摘要

目的

(1) 研究在常规实践中参加轻度抑郁症心理教育小组的受试者抑郁症状的改善情况是否与随机疗效试验中的改善情况相当;(2) 参加此干预措施的受试者在治疗后的抑郁症状水平是否与一般人群的抑郁症状水平相似。

设计

在荷兰的常规实践中,对20个心理教育小组的187名参与者在干预前后使用流行病学研究中心抑郁量表(CES-D)进行了检查。

方法

将受试者从测试前到测试后的标准化改善情况与参加同一干预措施随机试验的受试者的改善情况进行比较。此外,我们将测试后的分数与一般人群的分数进行了比较。

结果

常规实践中抑郁症状的改善程度与随机试验中的改善程度相同。然而,相当一部分参与者(54.5%)在测试后仍高于CES-D的临界分数,并且参与者的平均CES-D分数(M = 17.0;SD = 9.8)与一般人群的平均分数(M = 9.7;SD = 8.6)有显著差异(p < 0.01)。

结论

心理教育干预对有抑郁症状的人可能是一个重要的帮助。常规实践中抑郁症状方面的改善与随机试验中的改善没有差异。然而,参与者仍比一般人群抑郁得多,并且这种干预措施对许多人来说作为一种治疗形式是不够的。

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