Department of Psychology, University of California, Riverside, CA 92521, USA.
J Altern Complement Med. 2011 Aug;17(8):675-83. doi: 10.1089/acm.2011.0139. Epub 2011 Jul 1.
Despite the availability of many treatment options, depressive disorders remain a global public health problem. Even in affluent nations, 70% of reported cases either do not receive the recommended level of treatment or do not get treated at all, and this percentage does not reflect cases of depression that go unreported due to lack of access to health care, stigma, or other reasons. In developing countries, the World Health Organization estimates that <10% receive proper depression care due to poverty, stigma, and lack of governmental mental health resources and providers. Current treatments do not work for everyone, and even people who achieve remission face a high risk of recurrence and residual disability. The development of low-cost effective interventions that can serve either as initial therapy for mild symptoms or as adjunctive therapy for partial responders to medication is an immense unmet need. Positive activity interventions (PAIs) teach individuals ways to increase their positive thinking, positive affect, and positive behaviors. The majority of such interventions, which have obtained medium-size effect sizes, have been conducted with nondepressed individuals, but two randomized controlled studies in patients with mild clinical depression have reported promising initial findings. In this article, the authors review the relevant literature on the effectiveness of various types of PAIs, draw on social psychology, affective neuroscience and psychophamacology research to propose neural models for how PAIs might relieve depression, and discuss the steps needed to translate the potential promise of PAIs as clinical treatments for individuals with major and minor depressive disorders.
尽管有许多治疗选择，但抑郁症仍然是一个全球性的公共卫生问题。即使在富裕国家，70%的报告病例要么没有接受推荐水平的治疗，要么根本没有得到治疗，而这一比例并没有反映出由于缺乏医疗保健、耻辱感或其他原因而未报告的抑郁症病例。在发展中国家，世界卫生组织估计，由于贫困、耻辱感以及缺乏政府心理健康资源和提供者，只有<10%的人得到了适当的抑郁症治疗。目前的治疗方法并非对所有人都有效，即使那些已经缓解的人也面临着高复发和残留残疾的风险。开发低成本有效的干预措施是一个巨大的未满足的需求，这些干预措施可以作为轻度症状的初始治疗，也可以作为药物部分反应者的辅助治疗。积极活动干预（PAIs）教会个体如何增加积极的思考、积极的情绪和积极的行为。大多数此类干预措施已经在非抑郁症患者中进行了中等规模的效果评估，但有两项针对轻度临床抑郁症患者的随机对照研究报告了有希望的初步发现。在本文中，作者回顾了关于各种类型的 PAIs 的有效性的相关文献，借鉴社会心理学、情感神经科学和精神药理学研究，提出了 PAIs 缓解抑郁症的神经模型，并讨论了将 PAIs 作为治疗主要和次要抑郁症患者的临床治疗方法的潜在前景所需的步骤。
