Arkin Institute for Mental Health, Amsterdam, The Netherlands.
Br J Clin Psychol. 2011 Sep;50(3):268-82. doi: 10.1348/014466510X516975. Epub 2011 Mar 8.
OBJECTIVES AND DESIGN This study describes a randomized controlled trial which aimed to evaluate whether 16 sessions of psychotherapy combined with pharmacotherapy is more effective in relieving depression and improving social functioning than 8 sessions of psychotherapy combined with pharmacotherapy. METHODS. Randomized controlled trial comparing two treatment conditions with different psychotherapy dosages in out-patients with major depression. All patients studied had a baseline score of at least 14 points on the 17-item Hamilton Depression Rating Scale (HDRS). The two conditions consisted of 8- or 16-session short psychodynamic supportive psychotherapy, both in combination with pharmacotherapy. Efficacy was assessed using the 17-item HDRS, the clinical global impression of severity and of improvement, the depression subscale of the Ninety Symptom Checklist, the Quality of Life Depression Scale, and the Groningen Social Disability Schedule. RESULTS. Social functioning improved significantly in both groups. No significant differences were found between 8 and 16 sessions with regard to social functioning. A significant advantage is found for patients in remission on 5 of the 11 dimensions in social functioning over patients not in remission. CONCLUSIONS. At the end of treatment, no clear differences are found between 8 or 16 sessions of psychotherapy - both combined with pharmacotherapy - with regard to severity of depression and social functioning. It is thus still unknown if patients with major depression show more improvement in social functioning and less symptoms of depression after 16 sessions of combined therapy than after 8 sessions. Currently, it seems that for major depression 8 sessions of combined therapy are equally effective as 16 sessions.
目的和设计 本研究描述了一项随机对照试验，旨在评估 16 次心理治疗联合药物治疗是否比 8 次心理治疗联合药物治疗更能有效缓解抑郁和改善社会功能。
方法。 这是一项随机对照试验，比较了两种不同心理治疗剂量的治疗条件，患者为门诊重度抑郁症患者。所有研究患者的汉密尔顿抑郁量表（HDRS）的 17 项总分至少为 14 分。两种条件均包括 8 或 16 次短程心理动力支持性心理治疗，均与药物治疗联合使用。使用 HDRS 的 17 项总分、严重程度和改善程度的临床总体印象、90 项症状清单的抑郁分量表、生活质量抑郁量表和格罗宁根社会残疾量表评估疗效。
结果。 两组患者的社会功能均有显著改善。在社会功能方面，8 次和 16 次治疗之间没有发现显著差异。在社会功能的 11 个维度中有 5 个维度达到缓解的患者比未达到缓解的患者有显著优势。
结论。 在治疗结束时，8 或 16 次心理治疗 - 均与药物治疗联合使用 - 在抑郁严重程度和社会功能方面均未发现明显差异。因此，目前尚不清楚患有重度抑郁症的患者在接受联合治疗 16 次后是否比接受 8 次治疗后在社会功能方面有更多改善，抑郁症状更少。目前，对于重度抑郁症，8 次联合治疗似乎与 16 次联合治疗同样有效。
