Dammen Toril, Papageorgiou Costas, Wells Adrian
Toril Dammen, Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences , Post Box 1111, Blindern, 0317 Oslo , Norway.
Nord J Psychiatry. 2015 Feb;69(2):126-31. doi: 10.3109/08039488.2014.936502. Epub 2014 Aug 15.
Preliminary data support the implementation of individual metacognitive therapy (MCT) for depression. Given the focus of MCT on transpersonal processes, we hypothesized that this treatment should translate well to a group format. In this study, the effects and feasibility associated with group MCT for depression are reported.
Eleven patients who were consecutively referred by general practitioners to a specialist psychiatric practice in Norway participated in an open trial of the effects and feasibility associated with group MCT for depression. All of the patients met the DSM-IV criteria for major depressive disorder (MDD) and were monitored in a baseline period before attending 90-min weekly treatment sessions of group MCT for 10 weeks. The primary symptom outcome measure was severity of depression whilst secondary outcome measures included levels of anxiety, rumination and metacognitive beliefs. We also assessed recovery rates and changes in comorbid Axis I and Axis II diagnoses.
Large clinically significant improvements across all measures were detected at post-treatment and these were maintained at follow-up. Based on objectively defined recovery criteria, all patients were classified as recovered at post-treatment and 91% at 6 months follow-up. The intervention was also associated with significant reductions in comorbid diagnoses.
These preliminary data indicate that group MCT in the treatment of depression is effective, well accepted and it extends clinical application of MCT for depression to group formats as a potential cost-effective intervention.
初步数据支持对抑郁症实施个体元认知疗法(MCT)。鉴于MCT关注超个人过程,我们假设这种治疗方法应能很好地转化为团体形式。在本研究中,报告了团体MCT治疗抑郁症的效果及可行性。
11名由挪威全科医生连续转诊至专科精神科诊所的患者参与了一项关于团体MCT治疗抑郁症的效果及可行性的开放试验。所有患者均符合重度抑郁症(MDD)的DSM-IV标准,并在参加为期10周、每周90分钟的团体MCT治疗前的基线期接受监测。主要症状结局指标为抑郁严重程度,次要结局指标包括焦虑水平、沉思和元认知信念。我们还评估了康复率以及共病的轴I和轴II诊断的变化。
治疗后所有指标均出现了具有临床意义的大幅改善,且在随访时得以维持。根据客观定义的康复标准,所有患者在治疗后被归类为康复,在6个月随访时这一比例为91%。该干预措施还与共病诊断的显著减少相关。
这些初步数据表明,团体MCT治疗抑郁症是有效的,且易于接受,它将MCT治疗抑郁症的临床应用扩展到团体形式,作为一种潜在的具有成本效益的干预措施。