Black Dog Institute, Hospital Rd, Randwick, NSW, 2031, Australia.
J Affect Disord. 2011 Apr;130(1-2):138-44. doi: 10.1016/j.jad.2010.09.027. Epub 2010 Nov 20.
To examine the comparative effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behaviour Therapy (CBT) as treatments for non-melancholic depression.
Participants who met criteria for a current episode of major depressive disorder were randomly assigned to either an 8-week MBCT (n=19) or CBT (n=26) group therapy condition. They were assessed at pre-treatment, 8-week post-group, and 6- and 12-month follow-ups.
There were significant improvements in pre- to post-group depression and anxiety scores in both treatment conditions and no significant differences between the two treatment conditions. However, significant differences were found when participants in the two treatment conditions were dichotomized into those with a history of four or more episodes of depression vs those with less than four. In the CBT condition, participants with four or more previous episodes of depression demonstrated greater improvements in depression than those with less than four previous episodes. No such differences were found in the MBCT treatment condition. No significant differences in depression or anxiety were found between the two treatment conditions at 6- and 12-month follow-ups.
Small sample sizes in each treatment condition, especially at follow-up.
MBCT appears to be as effective as CBT in the treatment of current depression. However, CBT participants with four or more previous episodes of depression derived greater benefits at 8-week post-treatment than those with less than four episodes.
比较正念认知疗法(MBCT)和认知行为疗法(CBT)治疗非忧郁性抑郁症的疗效。
符合当前重性抑郁障碍发作标准的参与者被随机分配到 8 周的 MBCT(n=19)或 CBT(n=26)组治疗条件。他们在治疗前、8 周后以及 6 个月和 12 个月的随访中进行评估。
在两种治疗条件下,抑郁和焦虑评分都从治疗前到治疗后显著改善,且两种治疗条件之间无显著差异。然而,当将两种治疗条件下的参与者分为有 4 次或以上抑郁发作史的参与者和少于 4 次抑郁发作史的参与者时,发现了显著的差异。在 CBT 条件下,有 4 次或以上既往抑郁发作史的参与者在抑郁方面的改善大于有少于 4 次既往抑郁发作史的参与者。在 MBCT 治疗条件下则未发现这种差异。在 6 个月和 12 个月的随访中,两种治疗条件在抑郁或焦虑方面均无显著差异。
每种治疗条件的样本量都较小,尤其是在随访时。
MBCT 似乎与 CBT 一样有效,可用于治疗当前的抑郁症。然而,CBT 参与者中,有 4 次或以上既往抑郁发作史的参与者在 8 周治疗后比有少于 4 次抑郁发作史的参与者获益更大。