Universiti Kebangsaan Malaysia Medical Centre, Malaysia; University of Queensland, Australia.
University of Queensland, Australia; James Cook University, Singapore; Nanjing University, PR China.
Psychiatry Res. 2017 Aug;254:179-189. doi: 10.1016/j.psychres.2017.04.026. Epub 2017 Apr 18.
The aim of this study was to investigate the effectiveness of Individual Cognitive Behavior Therapy (ICBT) in treating patients with mood disorders with suicidal ideation. A total of 69 patients (48 females, 21 males) with the diagnoses above were randomly allocated to either the group of Treatment As Usual (TAU)+ICBT (n=33) or the TAU group (n=36). All participants completed the Beck Depression Inventory (BDI), Beck Scale for Suicide Ideation (BSS), Positive and Negative Suicide Ideation Inventory (PANSI), Beck Hopelessness Scale (BHS), and Depression Anxiety Stress Scale-21 (DASS-21). These questionnaires were administered at pre-treatment, midway through treatment (week 4), post-treatment (week 8), and at follow-ups after three months (week 20) and six months (week 32). Factorial ANOVA results showed that the TAU+ICBT patients improved significantly and at faster rate as compared to the TAU group, which showed improvement only from pre to mid treatment on DASS-D and BHS-T measures. The effect size (Cohen's d), for the TAU+ICBT group showed large effect (1.47) for depressive symptoms and suicidal ideation (1.00). These findings suggest that ICBT used in addition to the TAU, was effective in enhancing treatment outcome of patients with unipolar mood disorders as well as, reducing risk for suicide behavior.
本研究旨在探究个体认知行为疗法(ICBT)对有自杀意念的心境障碍患者的疗效。共有 69 名符合上述诊断标准的患者(48 名女性,21 名男性)被随机分配至常规治疗+ICBT 组(n=33)或常规治疗组(n=36)。所有参与者均完成贝克抑郁量表(BDI)、自杀意念量表(BSS)、正负向自杀意念量表(PANSI)、贝克绝望量表(BHS)和抑郁焦虑压力量表-21(DASS-21)。这些问卷在治疗前、治疗中期(第 4 周)、治疗后(第 8 周)以及治疗后 3 个月(第 20 周)和 6 个月(第 32 周)进行评估。方差分析结果显示,常规治疗+ICBT 组患者的改善情况明显优于常规治疗组,常规治疗组仅在 DASS-D 和 BHS-T 测量上显示出从治疗前到中期的改善。常规治疗+ICBT 组的效应量(Cohen's d)显示,在抑郁症状和自杀意念方面具有较大效应(1.47)。这些发现表明,在常规治疗的基础上增加 ICBT,可以有效提高单相心境障碍患者的治疗效果,降低自杀行为的风险。