低强度认知行为疗法治疗抑郁和焦虑的效果能持续多久？纵向队列研究中的缓解和复发。
How durable is the effect of low intensity CBT for depression and anxiety? Remission and relapse in a longitudinal cohort study.
机构信息
Department of Health Sciences and Centre for Health Economics, University of York, York, UK.
Leeds Community Healthcare NHS Trust, Leeds, UK.
出版信息
Behav Res Ther. 2017 Jul;94:1-8. doi: 10.1016/j.brat.2017.04.006. Epub 2017 Apr 18.
BACKGROUND
Depression and anxiety disorders are relapse-prone conditions, even after successful treatment with pharmacotherapy or psychotherapy. Cognitive behavioural therapy (CBT) is known to prevent relapse, but there is little evidence of the durability of remission after low intensity forms of CBT (LiCBT).
METHOD
This study aimed to examine relapse rates 12 months after completing routinely-delivered LiCBT. A cohort of 439 LiCBT completers with remission of symptoms provided monthly depression (PHQ-9) and anxiety (GAD-7) measures during 12 months after treatment. Survival analysis was conducted to model time-to-relapse while controlling for patient characteristics.
RESULTS
Overall, 53% of cases relapsed within 1 year. Of these relapse events, the majority (79%) occurred within the first 6 months post-treatment. Cases reporting residual depression symptoms (PHQ-9 = 5 to 9) at the end of treatment had significantly higher risk of relapse (hazard ratio = 1.90, p < 0.001).
CONCLUSIONS
The high rate of relapse after LiCBT highlights the need for relapse prevention, particularly for those with residual depression symptoms.
背景
抑郁症和焦虑症即使经过药物治疗或心理治疗成功治疗后也容易复发。认知行为疗法（CBT）已被证实可预防复发，但对于低强度的 CBT（LiCBT）治疗后的缓解持久性证据较少。
方法
本研究旨在检查完成常规 LiCBT 后 12 个月的复发率。439 名 LiCBT 完成者中有症状缓解者在治疗后 12 个月内每月提供抑郁（PHQ-9）和焦虑（GAD-7）的测量结果。生存分析用于建模复发时间，同时控制患者特征。
结果
总体而言，53%的病例在一年内复发。在这些复发事件中，大多数（79%）发生在治疗后 6 个月内。治疗结束时报告有残留抑郁症状（PHQ-9=5 到 9）的病例复发风险显著增加（危险比=1.90，p<0.001）。
结论
LiCBT 后复发率较高，突出了需要预防复发，特别是对于那些有残留抑郁症状的患者。
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