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成人轻度智力障碍(ID)患者的焦虑和抑郁的认知行为疗法(CBT):一项试点随机对照试验。

Cognitive behaviour therapy (CBT) for anxiety and depression in adults with mild intellectual disabilities (ID): a pilot randomised controlled trial.

机构信息

Department of Mental Health Sciences, University College Medical School, Charles Bell House, 67-73 Riding House Street, London W1W 7EY, UK.

出版信息

Trials. 2011 Apr 14;12:95. doi: 10.1186/1745-6215-12-95.


DOI:10.1186/1745-6215-12-95
PMID:21492437
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3102627/
Abstract

BACKGROUND: Several studies have showed that people with intellectual disabilities (ID) have suitable skills to undergo cognitive behavioural therapy (CBT). Case studies have reported successful use of cognitive behavioural therapy techniques (with adaptations) in people with ID. Modified cognitive behavioural therapy may be a feasible and effective approach for the treatment of depression, anxiety, and other mood disorders in ID. To date, two studies have reported group-based manaulised cognitive behavioural treatment programs for depression in people with mild ID. However, there is no individual manualised programme for anxiety or depression in people with intellectual disabilities. The aims of the study are to determine the feasibility of conducting a randomised controlled trial for CBT in people with ID. The data will inform the power calculation and other aspects of carrying out a definitive randomised controlled trial. METHODS: Thirty participants with mild ID will be allocated randomly to either CBT or treatment as usual (TAU). The CBT group will receive up to 20 hourly individual CBT over a period of 4 months. TAU is the standard treatment which is available to any adult with an intellectual disability who is referred to the intellectual disability service (including care management, community support, medical, nursing or social support). Beck Youth Inventories (Beck Anxiety Inventory & Beck Depression Inventory) will be administered at baseline; end of treatment (4 months) and at six months to evaluate the changes in depression and anxiety. Client satisfaction, quality of life and the health economics will be secondary outcomes. DISCUSSION: The broad outcome of the study will be to produce clear guidance for therapists to apply an established psychological intervention and identify how and whether it works with people with intellectual disabilities. TRIAL REGISTRATION: ISRCTN: ISRCTN38099525.

摘要

背景:多项研究表明,智力障碍(ID)患者具备接受认知行为疗法(CBT)的适当技能。案例研究报告称,在 ID 患者中成功使用了认知行为疗法技术(经改编)。改良认知行为疗法可能是治疗 ID 患者抑郁、焦虑和其他情绪障碍的一种可行且有效的方法。迄今为止,已有两项研究报告了针对轻度 ID 人群的基于小组的手动认知行为治疗抑郁方案。但是,针对 ID 患者的焦虑或抑郁,尚无个体化的手动方案。本研究旨在确定针对 ID 患者开展 CBT 随机对照试验的可行性。研究数据将为进行确定性随机对照试验的计算功效和其他方面提供信息。

方法:将 30 名轻度 ID 患者随机分配至 CBT 组或常规治疗组(TAU)。CBT 组将在 4 个月的时间内接受最多 20 小时的个体 CBT。TAU 是为任何转至智力残疾服务机构(包括护理管理、社区支持、医疗、护理或社会支持)的智力残疾成人提供的标准治疗。在基线、治疗结束时(4 个月)和 6 个月时将使用贝克青年抑郁自评量表(Beck Youth Inventories,包括贝克焦虑量表和贝克抑郁量表)评估抑郁和焦虑的变化。以客户满意度、生活质量和健康经济学为次要结局。

讨论:该研究的广泛结果将为治疗师提供明确的指导,以应用已确立的心理干预措施,并确定其如何以及是否对智力残疾患者有效。

试验注册:ISRCTN:ISRCTN38099525。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06aa/3102627/b64d0576c4ea/1745-6215-12-95-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06aa/3102627/b64d0576c4ea/1745-6215-12-95-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06aa/3102627/b64d0576c4ea/1745-6215-12-95-1.jpg

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