Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Depress Anxiety. 2014 Nov;31(11):934-40. doi: 10.1002/da.22323.
The present study examines the role of comorbid anxiety on depression outcomes for those receiving cognitive behavioral therapy (CBT) for depression by telephone (T-CBT) or face-to-face (FtF-CBT).
Three hundred twenty-five participants were randomized to T-CBT or FtF-CBT. Comorbid anxiety was measured using the Mini International Neuropsychiatric Interview and Generalized Anxiety Disorder 7. Depression was measured using the Hamilton Rating Scale for Depression and Patient Health Questionnaire 9.
A hierarchical model including the two-way interaction of treatment assignment and anxiety status indicated a significant effect for all outcome variables (Ps < .05). Post hoc t tests indicated T-CBT participants with comorbid anxiety disorders had significantly higher symptom severity over time compared to their T-CBT counterparts without anxiety (Ps < .001) and FtF-CBT counterparts with comorbid anxiety (Ps < .003). There were no significant differences in outcomes between those with and without comorbid anxiety disorders receiving FtF-CBT, or between T-CBT and FtF-CBT among those without comorbid anxiety disorders.
The findings indicate that the presence of baseline anxiety impacts the overall effect of T-CBT for the treatment of depression.
本研究通过电话认知行为疗法（T-CBT）或面对面认知行为疗法（FtF-CBT），考察了共病焦虑对接受抑郁治疗的患者的抑郁结局的影响。
325 名参与者被随机分配到 T-CBT 或 FtF-CBT 组。使用 Mini 国际神经精神访谈和广泛性焦虑障碍 7 项量表来评估共病焦虑。使用汉密尔顿抑郁评定量表和患者健康问卷 9 来评估抑郁。
包括治疗分配和焦虑状态的双向交互作用的层次模型表明，所有结果变量都有显著影响（P <.05）。事后 t 检验表明，与没有焦虑的 T-CBT 对照组相比（P <.001），以及与有共病焦虑的 FtF-CBT 对照组相比（P <.003），患有共病焦虑障碍的 T-CBT 参与者在整个治疗过程中的症状严重程度显著更高。在没有共病焦虑障碍的情况下，接受 FtF-CBT 的患者中，有和没有共病焦虑障碍的患者在结果上没有显著差异，也没有 T-CBT 和 FtF-CBT 之间的显著差异。
这些发现表明，基线焦虑的存在影响了 T-CBT 治疗抑郁的总体效果。
