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有和无基线抑郁发作的复发性抑郁障碍患者接受正念认知疗法的长期疗效。

LONG-TERM OUTCOME OF MINDFULNESS-BASED COGNITIVE THERAPY IN RECURRENTLY DEPRESSED PATIENTS WITH AND WITHOUT A DEPRESSIVE EPISODE AT BASELINE.

机构信息

Department of Psychiatry, Radboud University Nijmegen Medical Centre, The Netherlands.

Department for Health Evidence, Radboud University Nijmegen Medical Centre, The Netherlands.

出版信息

Depress Anxiety. 2015 Aug;32(8):563-9. doi: 10.1002/da.22369. Epub 2015 Apr 13.

Abstract

BACKGROUND

In a previous randomized controlled trial in patients with three or more previous depressive episodes, mindfulness-based cognitive therapy (MBCT) appeared to be equally effective in those who were depressed and those who were in remission at the start of the trial.

AIM

The aim of this study is to compare the 1-year outcome of MBCT in 124 remitted and 58 depressed patients who participated in the original trial and who were all offered MBCT either immediately or after a waiting period of 3 months.

METHODS

The course of depressive symptoms, rumination, mindfulness skills, and quality of life over the course of treatment and the 1-year follow-up period was analyzed. Linear mixed modeling was used to compare the outcome between remitted and depressed patients at baseline.

RESULTS

In the whole sample, levels of depression and rumination decreased and mindfulness and quality of life increased over treatment. Levels of depressive symptoms, mindfulness, and quality of life remained stable over the 1-year follow-up period. Rumination further decreased. Remitted and depressed patients at the start of the trial did not differ in terms of outcome during or after treatment.

CONCLUSIONS

Long-term outcome after MBCT in depressed patients was comparable to those who were in remission at the start of the trial. These findings lend further support to the notion that recurrent depressed patients meeting the criteria of a depressive episode do not need to be excluded from MBCT.

摘要

背景

在一项针对既往有三次或以上抑郁发作的患者的随机对照试验中,正念认知疗法(MBCT)在开始试验时抑郁和缓解的患者中均显示出同等疗效。

目的

本研究旨在比较 124 名缓解期和 58 名抑郁患者在原始试验中的 1 年结果,这些患者均接受 MBCT 治疗,且均立即或等待 3 个月后接受 MBCT。

方法

分析了治疗过程中和 1 年随访期间抑郁症状、反刍、正念技能和生活质量的变化。采用线性混合模型比较基线时缓解期和抑郁期患者的结局。

结果

在整个样本中,抑郁和反刍水平在治疗过程中下降,正念和生活质量增加。抑郁症状、正念和生活质量水平在 1 年随访期间保持稳定。反刍进一步下降。开始试验时缓解期和抑郁期患者在治疗期间和治疗后没有差异。

结论

在抑郁患者中接受 MBCT 的长期结果与开始试验时缓解的患者相当。这些发现进一步支持了这样一种观点,即符合抑郁发作标准的复发性抑郁患者不需要被排除在 MBCT 之外。

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