Lemmens L H J M, Arntz A, Peeters F, Hollon S D, Roefs A, Huibers M J H
Department of Clinical Psychological Science,Faculty of Psychology and Neuroscience,Maastricht University,Maastricht,The Netherlands.
Department of Psychiatry and Neuropsychology,Maastricht University Medical Centre,Maastricht,The Netherlands.
Psychol Med. 2015 Jul;45(10):2095-110. doi: 10.1017/S0033291715000033. Epub 2015 Feb 2.
Although both cognitive therapy (CT) and interpersonal psychotherapy (IPT) have been shown to be effective treatments for major depressive disorder (MDD), it is not clear yet whether one therapy outperforms the other with regard to severity and course of the disorder. This study examined the clinical effectiveness of CT v. IPT in a large sample of depressed patients seeking treatment in a Dutch outpatient mental health clinic. We tested whether one of the treatments was superior to the other at post-treatment and at 5 months follow-up. Furthermore, we tested whether active treatment was superior to no treatment. We also assessed whether initial depression severity moderated the effect of time and condition and tested for therapist differences.
Depressed adults (n = 182) were randomized to either CT (n = 76), IPT (n = 75) or a 2-month waiting list control (WLC) condition (n = 31). Main outcome was depression severity, measured with the Beck Depression Inventory - II (BDI-II), assessed at baseline, 2, 3, and 7 months (treatment phase) and monthly up to 5 months follow-up (8-12 months).
No differential effects between CT and IPT were found. Both treatments exceeded response in the WLC condition, and led to considerable improvement in depression severity that was sustained up to 1 year. Baseline depression severity did not moderate the effect of time and condition.
Within our power and time ranges, CT and IPT appeared not to differ in the treatment of depression in the acute phase and beyond.
尽管认知疗法(CT)和人际心理治疗(IPT)均已被证明是治疗重度抑郁症(MDD)的有效方法,但就该疾病的严重程度和病程而言,尚不清楚哪种疗法的效果更优。本研究在荷兰一家门诊心理健康诊所对大量寻求治疗的抑郁症患者样本中检验了CT与IPT的临床疗效。我们测试了两种治疗方法在治疗后及5个月随访时是否其中一种优于另一种。此外,我们测试了积极治疗是否优于不治疗。我们还评估了初始抑郁严重程度是否会调节时间和治疗条件的影响,并测试了治疗师之间的差异。
将成年抑郁症患者(n = 182)随机分为CT组(n = 76)、IPT组(n = 75)或2个月等待列表对照组(WLC,n = 31)。主要结局是抑郁严重程度,用贝克抑郁量表第二版(BDI-II)测量,在基线、第2、3和7个月(治疗阶段)以及长达5个月随访(8 - 12个月)期间每月进行评估。
未发现CT和IPT之间存在差异效应。两种治疗方法在WLC组的疗效均超过了预期,且导致抑郁严重程度有显著改善,并持续长达1年。基线抑郁严重程度并未调节时间和治疗条件的影响。
在我们的能力和时间范围内,CT和IPT在急性期及之后的抑郁症治疗中似乎没有差异。