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正念认知疗法作为预防复发性重度抑郁症的长期效果。

The long-term effects of mindfulness-based cognitive therapy as a relapse prevention treatment for major depressive disorder.

机构信息

School of Psychology, Level 4, Hughes Building, The University of Adelaide,South Australia 5005,

出版信息

Behav Cogn Psychother. 2010 Oct;38(5):561-76. doi: 10.1017/S135246581000010X. Epub 2010 Apr 7.

Abstract

BACKGROUND

Mindfulness-based Cognitive Therapy (MBCT) is a relapse prevention treatment for major depressive disorder.

METHOD

An observational clinical audit of 39 participants explored the long-term effects of MBCT using standardized measures of depression (BDI-II), rumination (RSS), and mindfulness (MAAS).

RESULTS

MBCT was associated with statistically significant reductions in depression from pre to post treatment. Gains were maintained over time (Group 1, 1-12 months, p = .002; Group 2, 13-24 months, p = .001; Group 3, 25-34 months, p = .04). Depression scores in Group 3 did begin to worsen, yet were still within the mild range of the BDI-II. Treatment variables such as attendance at "booster" sessions and ongoing mindfulness practice correlated with better depression outcomes (p = .003 and p = .03 respectively). There was a strong negative correlation between rumination and mindful attention (p < .001), consistent with a proposed mechanism of metacognition in the efficacy of MBCT.

CONCLUSION

It is suggested that ongoing MBCT skills and practice may be important for relapse prevention over the longer term. Larger randomized studies of the mechanisms of MBCT with longer follow-up periods are recommended.

摘要

背景

正念认知疗法(MBCT)是一种预防复发性抑郁症的方法。

方法

对 39 名参与者进行了一项观察性临床审计,使用抑郁(BDI-II)、反刍(RSS)和正念(MAAS)的标准化测量来探索 MBCT 的长期效果。

结果

MBCT 与治疗前到治疗后的抑郁程度呈统计学显著降低相关。随着时间的推移,收益得以维持(第 1 组,1-12 个月,p =.002;第 2 组,13-24 个月,p =.001;第 3 组,25-34 个月,p =.04)。第 3 组的抑郁评分开始恶化,但仍处于 BDI-II 的轻度范围内。治疗变量,如参加“强化”课程和持续的正念练习,与更好的抑郁结果相关(p =.003 和 p =.03 分别)。反刍与正念注意之间存在强烈的负相关(p <.001),这与 MBCT 疗效的元认知机制一致。

结论

建议在较长时间内,持续的 MBCT 技能和练习可能对预防复发很重要。建议进行更大规模的、具有更长随访期的、对 MBCT 机制的随机研究。

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