Hiller Wolfgang, Schindler Amrei
Johannes Gutenberg-Universität Mainz, Psychologisches Institut, Abteilung Klinische Psychologie und Psychotherapie, Mainz.
Psychother Psychosom Med Psychol. 2011 Mar;61(3-4):170-6. doi: 10.1055/s-0030-1255040. Epub 2010 Jul 19.
Treatment effects of psychotherapy are usually studied using analysis of mean differences, tests of significance and effect size measures. These strategies, however, do not answer the question of how large the proportion of patients is who responded to treatment or who even reached remission. This article compares 2 competing methods of response and remission analysis: The Reliable Change Index (RCI) according to Jacobson et al. and the method of percent symptom reduction (PSR). We applied both methods using a sample of 338 patients with DSM-IV major depressive disorder. A pre-post treatment effect of Cohen's d=1,16 (intention-to-treat) resulted for the Beck Depression Inventory (BDI), corresponding to response rates of 54-65% and remission rates of 42-48%. We demonstrate that the PSR method had some important advantages over the RCI. It is recommended to classify patients as responders in depression psychotherapy if they improve at least 50%.
心理治疗的疗效通常采用平均差异分析、显著性检验和效应量测量等方法进行研究。然而，这些策略并未回答有多少比例的患者对治疗有反应或甚至达到缓解的问题。本文比较了两种相互竞争的反应和缓解分析方法：雅各布森等人提出的可靠变化指数（RCI）和症状减轻百分比（PSR）方法。我们对338例符合DSM-IV重度抑郁症的患者样本应用了这两种方法。贝克抑郁量表（BDI）的意向性治疗前后的科恩d值为1.16，对应反应率为54%-65%，缓解率为42%-48%。我们证明，PSR方法相对于RCI具有一些重要优势。如果抑郁症心理治疗患者至少改善50%，建议将其归类为有反应者。
