Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia.
J Affect Disord. 2010 Feb;121(1-2):169-74. doi: 10.1016/j.jad.2009.06.002. Epub 2009 Jul 14.
There are high rates of co-occurring depression among young people with substance use disorders. While there is preliminary evidence for the effectiveness of integrated cognitive behaviour therapy (CBT) in combination with antidepressants among alcohol and substance dependent adolescents and adults with co-existing depression, no studies have examined the effectiveness of integrated CBT interventions in the absence of pharmacotherapy. The aim of the current study was to determine the outcomes of an integrated CBT intervention for co-occurring depression and substance misuse in young people presenting to a mental health setting.
Sixty young people (aged 15 to 25), with a DSM-IV diagnosis of Major Depressive Disorder and concurrent substance misuse (at least weekly use in the past month) or disorder were recruited from a public youth mental health service in Melbourne, Australia. Participants received 10 sessions of individual integrated CBT treatment delivered with case management over a 20-week period.
The intervention was associated with significant improvements in depression, anxiety, substance use, coping skills, depressive and substance use cognitions and functioning at mid- (10 weeks) and post- (20 weeks) treatment. These changes were maintained at 6 months follow-up (44 weeks).
These results provide preliminary evidence for the effectiveness of the integrated CBT intervention in young people with co-occurring depression and substance misuse. Further studies using randomised controlled designs are required to determine its efficacy.
在患有物质使用障碍的年轻人中，同时患有抑郁症的比例很高。虽然有初步证据表明，对于同时患有抑郁症的酒精和物质依赖青少年和成年人，将认知行为疗法（CBT）与抗抑郁药结合使用的效果较好，但尚无研究检查在没有药物治疗的情况下，整合 CBT 干预的效果。本研究旨在确定针对同时患有抑郁症和物质滥用的年轻人，在心理健康环境中进行整合 CBT 干预的结果。
从澳大利亚墨尔本的一家公共青年心理健康服务机构招募了 60 名患有 DSM-IV 诊断的重度抑郁症和并发物质滥用（过去一个月中至少每周使用一次）或障碍的年轻人（年龄在 15 至 25 岁之间）。参与者接受了 10 次个体整合 CBT 治疗，同时接受了 20 周的个案管理。
干预措施与抑郁、焦虑、物质使用、应对技能、抑郁和物质使用认知以及治疗中期（10 周）和治疗后（20 周）的功能显著改善相关。这些变化在 6 个月随访（44 周）时得到维持。
这些结果为同时患有抑郁症和物质滥用的年轻人的整合 CBT 干预措施的有效性提供了初步证据。需要使用随机对照设计的进一步研究来确定其疗效。
