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抑郁型乳腺癌患者的行为疗法:治疗结果的预测因素。

Behavior therapy for depressed breast cancer patients: predictors of treatment outcome.

机构信息

Department of Psychology, The University of Tennessee-Knoxville.

The University of Tennessee Medical Center Cancer Institute.

出版信息

J Consult Clin Psychol. 2015 Feb;83(1):225-31. doi: 10.1037/a0037704. Epub 2014 Aug 11.

Abstract

OBJECTIVE

Major depressive disorder (MDD) is the most common psychiatric disorder among breast cancer patients and is associated with substantial functional impairment. Although several outcome studies have explored the utility of psychotherapy for breast cancer patients with subsyndromal depression symptoms, only a few clinical trials have explored the efficacy of behavior therapy for patients with well-diagnosed MDD. An additional limitation of this research is that little is known about factors that best predict treatment outcome.

METHOD

In the context of a recent randomized trial of behavior activation and problem-solving therapy for depressed breast cancer patients (n = 80; Hopko et al., 2011), this study explored predictors of treatment outcome with selected demographic (age, education, marital status, occupational status), psychosocial (pretreatment depression and environmental reward, coexistent anxiety disorders, social support, history of psychotherapy) and cancer-related variables (cancer stage, duration of cancer diagnosis, and cancer treatment).

RESULTS

Positive treatment outcome as defined by Beck Depression Inventory-II (Beck et al., 1996) response and remission criteria was associated with being married, increased social support, not actively undergoing cancer treatment during psychotherapy, and having a history of psychotherapy.

CONCLUSIONS

The efficacy of behavior therapy for depressed breast cancer patients may depend on several patient variables. Implications for the provision of behavior therapy for breast cancer patients are discussed.

摘要

目的

重度抑郁症(MDD)是乳腺癌患者中最常见的精神疾病,与严重的功能障碍有关。尽管有几项结局研究探讨了心理治疗对有亚综合征抑郁症状的乳腺癌患者的效用,但只有少数临床试验探讨了行为疗法对确诊 MDD 患者的疗效。这项研究的另一个局限性是,对于哪些因素能最好地预测治疗结果,人们知之甚少。

方法

在最近一项针对患有抑郁症的乳腺癌患者的行为激活和问题解决治疗的随机试验(n = 80;Hopko 等人,2011)的背景下,本研究探讨了选定的人口统计学(年龄、教育、婚姻状况、职业状况)、心理社会(治疗前抑郁和环境奖励、共存的焦虑障碍、社会支持、心理治疗史)和癌症相关变量(癌症分期、癌症诊断持续时间和癌症治疗)对治疗结果的预测因素。

结果

根据贝克抑郁量表二(Beck 等人,1996)的反应和缓解标准定义的积极治疗结果与已婚、社会支持增加、在心理治疗期间未积极接受癌症治疗以及有心理治疗史有关。

结论

行为疗法对患有抑郁症的乳腺癌患者的疗效可能取决于几个患者变量。讨论了为乳腺癌患者提供行为治疗的意义。

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