Edward Hines Jr. VA Hospital, Center for the Management of Complex Chronic Care, Hines, IL 60141, USA.
Ann Behav Med. 2011 Apr;41(2):227-34. doi: 10.1007/s12160-010-9236-y.
Past research has found that a variety of physical, psychological, and social factors can affect quality of life (QOL). These previous findings suggest that interventions that address these factors could potentially improve QOL.
The purpose of this study was to examine whether cognitive behavioral therapy (CBT) can improve QOL, and if so, explore which factors might mediate this effect.
This is a secondary analysis of a randomized controlled trial. One hundred twenty-seven participants with multiple sclerosis and depression were randomly assigned to either a telephone-administered CBT (T-CBT) or telephone-administered supportive emotion-focused therapy (T-SEFT) intervention.
Patients assigned to T-CBT showed significantly greater improvements in QOL compared with those assigned to T-SEFT. The greater improvement in QOL among T-CBT recipients was mediated by improvements in depression and positive affect. There was also inconsistent support for the superior effect of CBT on QOL being mediated by improvement in fatigue.
T-CBT provided greater QOL benefits compared with T-SEFT, which controlled for non-specific treatment components. This study further suggests that T-CBT procedures specific to the management of depression and positive affect were uniquely useful in improving QOL.
过去的研究发现，各种身体、心理和社会因素都会影响生活质量（QOL）。这些先前的研究结果表明，针对这些因素的干预措施可能会改善生活质量。
本研究旨在探讨认知行为疗法（CBT）是否能提高生活质量，如果可以，进一步探索哪些因素可能在其中起到中介作用。
这是一项随机对照试验的二次分析。127 名多发性硬化症伴抑郁的患者被随机分配到电话实施的认知行为疗法（T-CBT）或电话实施的支持性情绪聚焦疗法（T-SEFT）干预组。
与接受 T-SEFT 的患者相比，接受 T-CBT 的患者在生活质量方面的改善更为显著。T-CBT 组患者生活质量的改善是通过抑郁和积极情绪的改善来介导的。CBT 在改善疲劳方面的效果也存在不一致的支持，认为其可能起到了中介作用。
与 T-SEFT 相比，T-CBT 提供了更大的生活质量获益，后者控制了非特异性治疗成分。这项研究进一步表明，针对抑郁和积极情绪管理的 T-CBT 程序在改善生活质量方面具有独特的作用。
