Luty Suzanne E, Carter Janet D, McKenzie Janice M, Rae Alma M, Frampton Christopher M A, Mulder Roger T, Joyce Peter R
Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, PO Box 4345, Christchurch, New Zealand.
Br J Psychiatry. 2007 Jun;190:496-502. doi: 10.1192/bjp.bp.106.024729.
Interpersonal psychotherapy and cognitive-behavioural therapy (CBT) are established as effective treatments for major depression. Controversy remains regarding their effectiveness for severe and melancholic depression.
To compare the efficacy of interpersonal psychotherapy and CBT in people receiving out-patient treatment for depression and to explore response in severe depression (Montgomery-Asberg Depression Rating Scale (MADRS) score above 30), and in melancholic depression.
Randomised clinical trial of 177 patients with a principal Axis I diagnosis of major depressive disorder receiving 16 weeks of therapy comprising 8-19 sessions. Primary outcome was improvement in MADRS score from baseline to end of treatment.
There was no difference between the two psychotherapies in the sample as a whole, but CBT was more effective than interpersonal psychotherapy in severe depression, and the response was comparable with that for mild and moder-ate depression. Melancholia did not predict poor response to either psychotherapy.
Both therapies are equally effective for depression but CBT may be preferred in severe depression.
人际心理治疗和认知行为疗法（CBT）已被确立为治疗重度抑郁症的有效方法。关于它们对重度和抑郁性抑郁症的有效性仍存在争议。
比较人际心理治疗和认知行为疗法对门诊抑郁症患者的疗效，并探讨重度抑郁症（蒙哥马利-阿斯伯格抑郁评定量表（MADRS）得分高于30）和抑郁性抑郁症的反应。
对177例主要轴I诊断为重度抑郁症的患者进行随机临床试验，接受为期16周、包括8 - 19次治疗的治疗。主要结局是从基线到治疗结束时MADRS得分的改善情况。
在整个样本中，两种心理治疗方法没有差异，但在重度抑郁症中，认知行为疗法比人际心理治疗更有效，其反应与轻度和中度抑郁症相当。抑郁性抑郁症并不能预测对任何一种心理治疗的反应不佳。
两种疗法对抑郁症同样有效，但在重度抑郁症中，认知行为疗法可能更受青睐。
