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患者对抑郁症元认知训练(D-MCT)治疗的看法:可接受性结果

Patients' perspectives on treatment with Metacognitive Training for Depression (D-MCT): Results on acceptability.

作者信息

Jelinek Lena, Moritz Steffen, Hauschildt Marit

机构信息

University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, 20246 Hamburg, Germany.

University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, 20246 Hamburg, Germany.

出版信息

J Affect Disord. 2017 Oct 15;221:17-24. doi: 10.1016/j.jad.2017.06.003. Epub 2017 Jun 7.

Abstract

BACKGROUND

Our understanding of how patients perceive and evaluate treatment for depression is scarce. Because dropout rates are high among individuals in treatment for depression, it is necessary to expand the focus of research to patients' perspectives on the treatment they receive. The aim of the two studies presented was to evaluate patient acceptance of Metacognitive Training for Depression (D-MCT), a highly standardized group intervention.

METHODS

Acceptability was evaluated in an open case series (Study 1, N = 70) and a randomized controlled trial (RCT; Study 2, N = 84). In both studies, participants rated their subjective appraisal on a 15-item questionnaire after administration of eight D-MCT modules. In Study 1, a subsample of patients also evaluated modules individually after each session. In Study 2, ratings were compared to an active control intervention (walking and psychoeducation sessions), and assessment was repeated at 6-months follow-up.

RESULTS

High rates of acceptance of the D-MCT were demonstrated in both studies immediately after treatment (post-assessment). In addition, the RCT showed better evaluations for the D-MCT than for the control condition at post-assessment as well as at 6-months follow-up. Weekly session evaluations in Study 1 indicated good acceptance for individual modules.

LIMITATIONS

Evaluations could only be obtained from completers; blinding of patients and therapists was not possible.

CONCLUSIONS

Results of the two studies suggest that D-MCT represents a promising group treatment in terms of patient acceptance and provide an example of how patients' feedback may be used to improve treatment.

摘要

背景

我们对患者如何看待和评估抑郁症治疗的了解很少。由于抑郁症治疗个体的脱落率很高,有必要将研究重点扩展到患者对所接受治疗的看法上。所呈现的两项研究的目的是评估患者对抑郁症元认知训练(D-MCT)的接受程度,这是一种高度标准化的团体干预。

方法

在一个开放病例系列(研究1,N = 70)和一项随机对照试验(RCT;研究2,N = 84)中评估可接受性。在两项研究中,参与者在接受八个D-MCT模块后,通过一份15项问卷对他们的主观评价进行评分。在研究1中,部分患者子样本在每次疗程后也对各个模块进行单独评估。在研究2中,将评分与积极对照干预(步行和心理教育课程)进行比较,并在6个月随访时重复评估。

结果

在两项研究中,治疗后(评估后)立即显示出对D-MCT的高接受率。此外,RCT显示,在评估后以及6个月随访时,对D-MCT的评价优于对照条件。研究1中的每周疗程评估表明对各个模块的接受度良好。

局限性

评估只能从完成者中获得;患者和治疗师无法进行盲法。

结论

两项研究的结果表明,就患者接受度而言,D-MCT是一种有前景的团体治疗方法,并提供了一个如何利用患者反馈来改善治疗的例子。

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