Christopher Michael S, Jacob Karen L, Neuhaus Edmund C, Neary Timothy J, Fiola Lauren A
Pacific University, 511 SW 10th Avenue, Portland, OR 97205, USA.
J Psychiatr Pract. 2009 Mar;15(2):95-102. doi: 10.1097/01.pra.0000348362.11548.5f.
To examine the relationship between cognitive and behavioral changes associated with cognitive-behavioral therapy (CBT) and treatment response in an intensive partial hospital (PH) setting.
Study participants were 105 patients with mood disorders receiving treatment in a private psychiatric PH setting. The flexible treatment model used evidence-based CBT interventions adapted to the PH context, with emphases on psychoeducation and skills training. Participants completed self-report measures at admission and discharge to assess psychological distress, depression, negative automatic thoughts, and behavioral activation. Mean treatment duration was 9 days.
Decreased negative automatic thoughts and increased behavioral activation predicted reduction of depressive symptoms; however, only decreased negative automatic thoughts was predictive of patients' overall level of psychological distress.
These results suggest that a CBT intervention adapted for use in a PH setting can be an effective treatment for severe mood disorders. Furthermore, although the design used in this study precludes causal inferences, depressive symptom improvement appears to be associated with decreased negative automatic thoughts and increased behavioral activation. Implications for the delivery of CBT in PH programs and future directions for research are discussed.
在强化日间医院（PH）环境中，研究与认知行为疗法（CBT）相关的认知和行为变化与治疗反应之间的关系。
研究参与者为105名在私立精神科日间医院接受治疗的情绪障碍患者。灵活治疗模式采用基于证据的CBT干预措施，并根据日间医院的情况进行调整，重点是心理教育和技能培训。参与者在入院和出院时完成自我报告测量，以评估心理困扰、抑郁、消极自动思维和行为激活情况。平均治疗时长为9天。
消极自动思维减少和行为激活增加预示着抑郁症状的减轻；然而，只有消极自动思维的减少能预测患者的整体心理困扰水平。
这些结果表明，适用于日间医院环境的CBT干预可以有效治疗严重情绪障碍。此外，尽管本研究采用的设计排除了因果推断，但抑郁症状的改善似乎与消极自动思维的减少和行为激活的增加有关。讨论了在日间医院项目中实施CBT的意义以及未来的研究方向。
