Koenig Harold G
Departments of Psychiatry and Medicine, Duke University Medical Center, Box 3400 Medical Center, Durham, NC 27705, USA.
Depress Res Treat. 2012;2012:460419. doi: 10.1155/2012/460419. Epub 2012 Jun 13.
This paper (1) reviews the physical and religious barriers to CBT that disabled medically ill-depressed patients face, (2) discusses research on the relationship between religion and depression-induced physiological changes, (3) describes an ongoing randomized clinical trial of religious versus secular CBT in chronically ill patients with mild-to-moderate major depression designed to (a) overcome physical and religious barriers to CBT and (b) compare the efficacy of religious versus secular CBT in relieving depression and improving immune and endocrine functions, and (4) presents preliminary results that illustrate the technical difficulties that have been encountered in implementing this trial. CBT is being delivered remotely via instant messaging, telephone, or Skype, and Christian, Jewish, Muslim, Buddhist, and Hindu versions of religious CBT are being developed. The preliminary results described here are particular to the technologies employed in this study and are not results from the CBT clinical trial whose findings will be published in the future after the study ends and data are analyzed. The ultimate goal is to determine if a psychotherapy delivered remotely that integrates patients' religious resources improves depression more quickly than a therapy that ignores them, and whether religious CBT is more effective than conventional CBT in reversing depression-induced physiological changes.
本文(1)回顾了身患疾病且患有抑郁症的残疾患者在接受认知行为疗法(CBT)时所面临的身体和宗教方面的障碍,(2)探讨了宗教与抑郁症引发的生理变化之间关系的研究,(3)描述了一项正在进行的针对患有轻至中度重度抑郁症的慢性病患者的宗教CBT与世俗CBT的随机临床试验,该试验旨在(a)克服CBT的身体和宗教障碍,以及(b)比较宗教CBT与世俗CBT在缓解抑郁以及改善免疫和内分泌功能方面的疗效,并且(4)展示了初步结果,这些结果说明了在实施该试验过程中遇到的技术难题。CBT正通过即时通讯、电话或Skype进行远程提供,同时正在开发基督教、犹太教、穆斯林、佛教和印度教版本的宗教CBT。这里所描述的初步结果特定于本研究中所采用的技术,并非来自CBT临床试验的结果,该试验的结果将在研究结束并分析数据后于未来发表。最终目标是确定一种远程提供的、整合了患者宗教资源的心理疗法是否比忽视这些资源的疗法能更快地改善抑郁症,以及宗教CBT在逆转抑郁症引发的生理变化方面是否比传统CBT更有效。