Finucane Andy, Mercer Stewart W
General Practice and Primary Care, Division of Community-based Sciences, University of Glasgow, Glasgow G12 9LX, UK.
BMC Psychiatry. 2006 Apr 7;6:14. doi: 10.1186/1471-244X-6-14.
Mindfulness Based Cognitive Therapy (MBCT) is an 8-week course developed for patients with relapsing depression that integrates mindfulness meditation practices and cognitive theory. Previous studies have demonstrated that non-depressed participants with a history of relapsing depression are protected from relapse by participating in the course. This exploratory study examined the acceptability and effectiveness of MBCT for patients in primary care with active symptoms of depression and anxiety
13 patients with recurrent depression or recurrent depression and anxiety were recruited to take part in the study. Semi-structured qualitative interviews were conducted three months after completing the MBCT programme. A framework approach was used to analyse the data. Beck depression inventories (BDI-II) and Beck anxiety inventories (BAI) provided quantitative data and were administered before and three months after the intervention.
The qualitative data indicated that mindfulness training was both acceptable and beneficial to the majority of patients. For many of the participants, being in a group was an important normalising and validating experience. However most of the group believed the course was too short and thought that some form of follow up was essential. More than half the patients continued to apply mindfulness techniques three months after the course had ended. A minority of patients continued to experience significant levels of psychological distress, particularly anxiety. Statistically significant reductions in mean depression and anxiety scores were observed; the mean pre-course depression score was 35.7 and post-course score was 17.8 (p = 0.001). A similar reduction was noted for anxiety with a mean pre-course anxiety score of 32.0 and mean post course score of 20.5 (p = 0.039). Overall 8/11 (72%) patients showed improvements in BDI and 7/11 (63%) patients showed improvements in BAI. In general the results of the qualitative analysis agreed well with the quantitative changes in depression and anxiety reported.
The results of this exploratory mixed methods study suggest that mindfulness based cognitive therapy may have a role to play in treating active depression and anxiety in primary care.
基于正念的认知疗法(MBCT)是一门为复发性抑郁症患者开发的为期8周的课程,它融合了正念冥想练习和认知理论。先前的研究表明,有复发性抑郁症病史的非抑郁症参与者通过参加该课程可预防复发。这项探索性研究考察了MBCT对有抑郁和焦虑活动症状的初级保健患者的可接受性和有效性。
招募了13名患有复发性抑郁症或复发性抑郁症与焦虑症的患者参与研究。在完成MBCT课程三个月后进行了半结构化定性访谈。采用框架法分析数据。贝克抑郁量表(BDI-II)和贝克焦虑量表(BAI)提供定量数据,在干预前和干预三个月后进行施测。
定性数据表明,正念训练对大多数患者来说既可以接受又有益。对许多参与者而言,参加小组活动是一种重要的使他们感觉正常和得到认可的体验。然而,大多数组员认为课程太短,并认为某种形式的随访至关重要。超过一半的患者在课程结束三个月后仍继续应用正念技巧。少数患者仍持续经历显著程度的心理困扰,尤其是焦虑。观察到抑郁和焦虑平均得分有统计学意义的降低;课程前抑郁平均得分为35.7,课程后得分为17.8(p = 0.001)。焦虑方面也有类似的降低,课程前焦虑平均得分为32.0,课程后平均得分为20.5(p = 0.039)。总体而言,11名患者中有8名(72%)BDI得分有所改善,11名患者中有7名(63%)BAI得分有所改善。一般来说,定性分析结果与所报告的抑郁和焦虑的定量变化吻合良好。
这项探索性混合方法研究的结果表明,基于正念的认知疗法可能在治疗初级保健中的活动性抑郁和焦虑方面发挥作用。