Mood and Anxiety Disorders Unit, Department of Neuroscience, University of Turin, Turin, Italy.
Psychother Psychosom. 2010;79(5):295-302. doi: 10.1159/000318296. Epub 2010 Jul 9.
Until now no studies have investigated the benefits of adding brief dynamic therapy (BDT) to medication in obsessive-compulsive disorder (OCD), while a number of recent investigations have demonstrated the efficacy of supplemental BDT among patients with major depressive disorders (MDD). The objective of the present study was to explore the efficacy of BDT combined with pharmacotherapy in comparison with pharmacotherapy alone in the treatment of OCD with concurrent MDD.
A 12-month randomized clinical trial compared a standard selective serotonin reuptake inhibitor treatment with (n = 27) or without (n = 30) supplemental BDT in patients with OCD and concurrent MDD. Supplemental BDT was added during the first 16-week trial; all patients continued to be treated with only pharmacotherapy in the following continuation phase. The primary efficacy assessments were the Yale-Brown Obsessive Compulsive Scale and the 17-item Hamilton Rating Scale for Depression; the secondary efficacy measures included the Clinical Global Impression scale and the Global Assessment of Functioning. The data analysis was conducted on the 'intent-to-treat (ITT) efficacy patient sample'.
Fifty patients completed the study. No difference between the 2 treatment groups was found at any point by any assessment method in the ITT study sample.
Supplemental BDT in the treatment of patients with OCD with concurrent MDD who are receiving effective medication has no significant clinical effect on both obsessive and depressive symptoms.
到目前为止,还没有研究调查在强迫症 (OCD) 中添加短暂动态治疗 (BDT) 对药物治疗的益处,而最近的一些研究已经证明了补充 BDT 在重度抑郁症 (MDD) 患者中的疗效。本研究的目的是探讨 BDT 联合药物治疗与单纯药物治疗在同时患有 MDD 的 OCD 患者中的疗效。
一项为期 12 个月的随机临床试验比较了标准选择性 5-羟色胺再摄取抑制剂治疗与(n = 27)或不联合(n = 30)补充 BDT 在 OCD 合并 MDD 患者中的疗效。补充 BDT 在最初的 16 周试验中添加;所有患者在随后的延续阶段仅继续接受药物治疗。主要疗效评估指标是耶鲁-布朗强迫症量表和汉密尔顿抑郁量表 17 项;次要疗效测量包括临床总体印象量表和总体功能评估。数据分析基于“意向治疗 (ITT) 疗效患者样本”进行。
五十名患者完成了研究。在 ITT 研究样本中,任何评估方法都没有发现两组在任何时间点的差异。
在接受有效药物治疗的同时患有 MDD 的 OCD 患者中添加补充 BDT 对强迫症和抑郁症状均无显著临床效果。