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伴有抑郁和盆腔痛的妇女人际心理治疗与增强常规治疗的随机对照试验。

Randomized controlled trial of interpersonal psychotherapy versus enhanced treatment as usual for women with co-occurring depression and pelvic pain.

机构信息

Department of Psychiatry, University of Rochester Medical Center, United States.

Department of Psychiatry, University of Rochester Medical Center, United States.

出版信息

J Psychosom Res. 2014 Oct;77(4):264-72. doi: 10.1016/j.jpsychores.2014.07.016. Epub 2014 Jul 26.

Abstract

OBJECTIVE

Our study assessed the effectiveness of Interpersonal Psychotherapy (IPT) tailored for biomedical patients with depression and pain. IPT was compared to enhanced treatment as usual (E-TAU) among women with co-occurring depression and chronic pain presenting for care at a women's health or family medicine practice. We hypothesized that women presenting to urban medical practices with depression and chronic pain would benefit from IPT tailored to address their needs to a greater degree than from E-TAU.

METHODS

We conducted a randomized controlled psychotherapy trial of 61 women from 2 urban medical practices who met criteria for major depressive disorder and chronic pelvic pain. Participants were assigned to receive either 8 sessions of IPT or a facilitated psychotherapy referral to a community mental health center, and assessed for depression, social interactions, and pain at 0-, 12-, 24-, and 36-weeks, with score on the Hamilton Rating Scale for Depression as the primary outcome. Both intent-to-treat (ITT) and causal modeling analyses correcting for treatment attendance were conducted.

RESULTS

ITT analyses were not significant. In causal modeling analyses, participants assigned to IPT showed significantly more improvement for depression and social interactions, but not for pain.

CONCLUSION

IPT may be a viable option as part of a comprehensive treatment program for women in medical practices with depression and chronic pain.

CLINICAL TRIALS REGISTRATION

ClinicalTrials.gov, NCT00895999.

摘要

目的

我们的研究评估了针对患有抑郁和疼痛的生物医学患者量身定制的人际心理治疗 (IPT) 的有效性。IPT 与增强的常规治疗 (E-TAU) 进行了比较,比较对象为在妇女健康或家庭医学诊所就诊的同时患有抑郁和慢性疼痛的女性。我们假设,在城市医疗实践中出现抑郁和慢性疼痛的女性将从针对其需求量身定制的 IPT 中获益更大,而不是从 E-TAU 中获益。

方法

我们对 2 家城市医疗实践中的 61 名符合重度抑郁障碍和慢性盆腔疼痛标准的女性进行了一项随机对照心理治疗试验。参与者被分配接受 8 节 IPT 或促进社区心理健康中心的心理治疗转诊,并在 0、12、24 和 36 周时评估抑郁、社交互动和疼痛情况,以汉密尔顿抑郁评定量表 (Hamilton Rating Scale for Depression) 得分为主要结局。进行了意向治疗 (ITT) 和因果建模分析,以纠正治疗参与度。

结果

ITT 分析不显著。在因果建模分析中,被分配到 IPT 的参与者在抑郁和社交互动方面有显著的改善,但在疼痛方面没有改善。

结论

IPT 可能是医疗实践中患有抑郁和慢性疼痛的女性综合治疗方案的可行选择。

临床试验注册

ClinicalTrials.gov,NCT00895999。

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