Pieh Christoph, Altmeppen Jürgen, Neumeier Susanne, Loew Thomas, Angerer Michael, Lahmann Claas
Abteilung für Psychosomatische Medizin, Universitätsklinikum Regensburg.
Psychiatr Prax. 2012 Aug;39(6):280-5. doi: 10.1055/s-0032-1305097. Epub 2012 Aug 27.
Although gender differences are increasingly the focus of current research, gender aspects in the response to pharmacological and non-pharmacological treatment of depression still remain unclear. The aim of this study was to analyze the impact of gender on the outcome of a CBT-orientated multimodal treatment in depressed outpatients with chronic pain.
A total of 298 patients (154 women) underwent a standardized five-week CBT-orientated multimodal treatment. Depressive symptoms were measured at the beginning and end of the treatment with the German version of the Center for Epidemiological Studies Depression Scale (CES-D).
The improvement of depressive symptoms showed an effect size (ES) of 0.81 in the total sample. However, women improved considerably more (ES 0.96) than did men (ES 0.65) and these gender differences are seen in the complete sample (t = 2.757, df = 296, p = 0.006) as well as in the group without received antidepressants (t = 2.325, df = 151, p = 0.021).
Women with a depressive disorder and chronic pain benefit significantly more from a CBT-orientated multimodal treatment and exhibit a considerably greater reduction of depressive symptoms than do men. These distinctions are not due to differences in received antidepressant medication, psychiatric comorbidities or educational background.
尽管性别差异日益成为当前研究的焦点，但抑郁症药物和非药物治疗反应中的性别因素仍不明确。本研究的目的是分析性别对慢性疼痛抑郁症门诊患者以认知行为疗法（CBT）为导向的多模式治疗结果的影响。
共有298名患者（154名女性）接受了为期五周的标准化CBT导向多模式治疗。治疗开始和结束时，用德语版的流行病学研究中心抑郁量表（CES-D）测量抑郁症状。
总样本中抑郁症状的改善显示效应量（ES）为0.81。然而，女性改善程度（ES 0.96）比男性（ES 0.65）大得多，并且在整个样本（t = 2.757，自由度 = 296，p = 0.006）以及未接受抗抑郁药的组中（t = 2.325，自由度 = 151，p = 0.021）均可见到这些性别差异。
患有抑郁症和慢性疼痛的女性从CBT导向的多模式治疗中获益明显更多，且与男性相比，抑郁症状的减轻程度显著更大。这些差异并非由于接受抗抑郁药物、精神共病或教育背景的不同所致。
