Malogiannis Ioannis A, Arntz Arnoud, Spyropoulou Areti, Tsartsara Eirini, Aggeli Aikaterini, Karveli Spyridoula, Vlavianou Miranda, Pehlivanidis Artemios, Papadimitriou George N, Zervas Iannis
1st Department of Psychiatry, Eginition Hospital, Athens Medical School, Athens, Greece; Greek Society of Schema Therapy, 10555 Athens, Greece.
Maastricht University, The Netherlands.
J Behav Ther Exp Psychiatry. 2014 Sep;45(3):319-29. doi: 10.1016/j.jbtep.2014.02.003. Epub 2014 Feb 24.
This study tested the effectiveness of schema therapy (ST) for patients with chronic depression.
Twelve patients with a diagnosis of chronic depression participated. The treatment protocol consisted of 60 sessions, with the first 55 sessions offered weekly and the last five sessions on a biweekly basis. A single case series A-B-C design, with 6 months follow-up was used. Baseline (A) was a wait period of 8 weeks. Baseline was followed by introduction to ST and bonding to therapist (phase B) with individually tailored length of 12-16 sessions, after which further ST was provided (phase C) up to 60 sessions (included the sessions given as introduction). Patients were assessed with Hamilton Rating Scale for Depression three times during baseline, at the end of phase B, then every 12 weeks until the end of treatment and at 6 months follow-up. Secondary outcome measures were the Hamilton Rating Scale for Anxiety and the Young Schema Questionnaire.
At the end of treatment 7 patients (approximately 60%) remitted or satisfactorily responded. The mean HRSD dropped from 21.07 during baseline to 9.40 at post-treatment and 10.75 at follow-up. The effects were large and the gains of treatment were maintained at 6-month follow-up. Only one patient dropped out for reasons not related to treatment.
The lack of control group, the small sample and the lack of a multiple baseline case series.
This preliminary study supports the use of ST as an effective treatment for chronic depression.
本研究测试了图式疗法（ST）对慢性抑郁症患者的有效性。
12名被诊断为慢性抑郁症的患者参与了研究。治疗方案包括60次治疗，前55次每周进行一次，最后5次每两周进行一次。采用单病例系列A - B - C设计，并进行6个月的随访。基线期（A）为8周的等待期。基线期之后是引入图式疗法并与治疗师建立联系（B阶段），该阶段时长为12 - 16次，根据个体情况量身定制，之后提供进一步的图式疗法（C阶段），直至60次治疗（包括作为引入部分的治疗次数）。在基线期、B阶段结束时、治疗结束前每12周以及6个月随访时，使用汉密尔顿抑郁评定量表对患者进行三次评估。次要结局指标为汉密尔顿焦虑评定量表和青年图式问卷。
治疗结束时，7名患者（约60%）缓解或有满意反应。汉密尔顿抑郁评定量表平均得分从基线期的21.07降至治疗后的9.40以及随访时的10.75。治疗效果显著，且治疗所取得的改善在6个月随访时得以维持。仅有1名患者因与治疗无关的原因退出。
缺乏对照组、样本量小以及缺乏多基线病例系列。
这项初步研究支持将图式疗法作为慢性抑郁症的一种有效治疗方法。
