Areán Patricia A, Gum Amber, McCulloch Charles E, Bostrom Alan, Gallagher-Thompson Dolores, Thompson Larry
Department of Psychiatry, University of California, San Francisco, CA 94143-0984, USA.
Psychol Aging. 2005 Dec;20(4):601-9. doi: 10.1037/0882-7974.20.4.601.
The purpose of this study was to compare cognitive-behavioral group therapy (CBGT), clinical case management (CCM), and their combination (CBGT + CCM) to treat depression in low-income older adults (60+). Sixty-seven participants with major depressive disorder or dysthymia were randomly assigned and entered into 1 of the 3 treatment conditions for 6 months. They were followed for 18 months after treatment initiation on depression and functional outcomes. CCM and CBGT + CCM led to greater improvements in depressive symptoms than CBGT, but CBGT led to greater improvements in physical functioning. All 3 conditions resulted in similar reduction of needs. Findings suggest that disadvantaged older adults with depression benefit from increased access to social services either alone or combined with psychotherapy.
本研究的目的是比较认知行为团体治疗(CBGT)、临床病例管理(CCM)及其联合治疗(CBGT+CCM)对低收入老年人(60岁及以上)抑郁症的治疗效果。67名患有重度抑郁症或心境恶劣障碍的参与者被随机分配,并进入三种治疗方案中的一种,为期6个月。在治疗开始后,对他们进行了18个月的跟踪,观察抑郁和功能结局。与CBGT相比,CCM和CBGT+CCM在改善抑郁症状方面效果更显著,但CBGT在改善身体功能方面效果更显著。所有三种治疗方案在减少需求方面效果相似。研究结果表明,处境不利的老年抑郁症患者单独或结合心理治疗,通过增加获得社会服务的机会而受益。