GGzE, Institute of Mental Health Care Eindhoven and the Kempen, P.O. Box 909, 5600 AX Eindhoven, The Netherlands; Department of Psychiatry and Psychology, Maastricht University Medical Centre, European Graduate School of Neuroscience, SEARCH, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
World Psychiatry. 2014 Feb;13(1):68-77. doi: 10.1002/wps.20090.
In depression, the ability to experience daily life positive affect predicts recovery and reduces relapse rates. Interventions based on the experience sampling method (ESM-I) are ideally suited to provide insight in personal, contextualized patterns of positive affect. The aim of this study was to examine whether add-on ESM-derived feedback on personalized patterns of positive affect is feasible and useful to patients, and results in a reduction of depressive symptomatology. Depressed outpatients (n=102) receiving pharmacological treatment participated in a randomized controlled trial with three arms: an experimental group receiving add-on ESM-derived feedback, a pseudo-experimental group participating in ESM but receiving no feedback, and a control group. The experimental group participated in an ESM procedure (three days per week over a 6-week period) using a palmtop. This group received weekly standardized feedback on personalized patterns of positive affect. Hamilton Depression Rating Scale - 17 (HDRS) and Inventory of Depressive Symptoms (IDS) scores were obtained before and after the intervention. During a 6-month follow-up period, five HDRS and IDS assessments were completed. Add-on ESM-derived feedback resulted in a significant and clinically relevant stronger decrease in HDRS score relative to the control group (p<0.01; -5.5 point reduction in HDRS at 6 months). Compared to the pseudo-experimental group, a clinically relevant decrease in HDRS score was apparent at 6 months (B=-3.6, p=0.053). Self-reported depressive complaints (IDS) yielded the same pattern over time. The use of ESM-I was deemed acceptable and the provided feedback easy to understand. Patients attempted to apply suggestions from ESM-derived feedback to daily life. These data suggest that the efficacy of traditional passive pharmacological approach to treatment of major depression can be enhanced by using person-tailored daily life information regarding positive affect.
在抑郁症中，体验日常生活积极情绪的能力可以预测康复并降低复发率。基于经验采样方法（ESM-I）的干预措施非常适合提供个人、情境化积极情绪模式的洞察力。本研究的目的是检验基于ESM 的积极情绪个性化模式的附加反馈是否对患者可行且有用，是否能降低抑郁症状。接受药物治疗的抑郁门诊患者（n=102）参与了一项随机对照试验，分为三组：实验组接受基于 ESM 的附加反馈，假性实验组参与 ESM 但不接受反馈，对照组。实验组使用掌上电脑参与 ESM 程序（六周内每周三天）。该组每周都会收到关于个性化积极情绪模式的标准化反馈。在干预前后，分别使用汉密尔顿抑郁量表-17 项（HDRS）和抑郁症状量表（IDS）进行评估。在 6 个月的随访期间，完成了五次 HDRS 和 IDS 评估。与对照组相比，基于 ESM 的附加反馈导致 HDRS 评分显著且具有临床意义的降低（p<0.01；HDRS 评分在 6 个月时降低 5.5 分）。与假性实验组相比，6 个月时 HDRS 评分的临床显著降低（B=-3.6，p=0.053）。自我报告的抑郁症状（IDS）在时间上也呈现出相同的模式。ESM-I 的使用被认为是可以接受的，提供的反馈也很容易理解。患者试图将 ESM 反馈中的建议应用于日常生活。这些数据表明，通过使用针对积极情绪的个性化日常生活信息，可以增强传统被动药物治疗方法治疗重度抑郁症的疗效。
