Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK; Black Dog Institute, University of New South Wales, Sydney, Australia.
Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK.
Behav Res Ther. 2018 Jun;105:1-9. doi: 10.1016/j.brat.2018.03.004. Epub 2018 Mar 15.
Impaired ability to recall specific autobiographical memories is characteristic of depression, which when reversed, may have therapeutic benefits. This cluster-randomized controlled pilot trial investigated efficacy and aspects of acceptability, and feasibility of MEmory Specificity Training (MEST) relative to Psychoeducation and Supportive Counselling (PSC) for Major Depressive Disorder (N = 62). A key aim of this study was to determine a range of effect size estimates to inform a later phase trial. Assessments were completed at baseline, post-treatment and 3-month follow-up. The cognitive process outcome was memory specificity. The primary clinical outcome was symptoms on the Beck Depression Inventory-II at 3-month follow-up. The MEST group demonstrated greater improvement in memory specificity relative to PSC at post-intervention (d = 0.88) and follow-up (d = 0.74), relative to PSC. Both groups experienced a reduction in depressive symptoms at 3-month follow-up (d = 0.67). However, there was no support for a greater improvement in depressive symptoms at 3 months following MEST relative to PSC (d = -0.04). Although MEST generated changes on memory specificity and improved depressive symptoms, results provide no indication that MEST is superior to PSC in the resolution of self-reported depressive symptoms. Implications for later-phase definitive trials of MEST are discussed.
记忆特异性训练对抑郁症的疗效及可接受性、可行性的初步研究:一项随机对照试验
记忆特异性受损是抑郁症的特征之一,而改善这种记忆特异性可能具有治疗益处。本项集群随机对照试验旨在研究记忆特异性训练(MEST)与心理教育和支持性咨询(PSC)治疗重度抑郁症的疗效,以及其可接受性和可行性(N=62)。本研究的一个主要目的是确定一系列的效应量估计值,以为后续的试验提供信息。评估在基线、治疗后和 3 个月随访时进行。认知过程的结果是记忆特异性,主要的临床结果是 3 个月随访时贝克抑郁量表 II 的症状。与 PSC 相比,MEST 组在干预后(d=0.88)和随访时(d=0.74)的记忆特异性改善更大,而 PSC 组则在 3 个月随访时(d=0.67)的抑郁症状有所减轻。然而,MEST 组在 3 个月后的抑郁症状改善并不优于 PSC 组(d=-0.04)。尽管 MEST 组在记忆特异性和改善抑郁症状方面产生了变化,但结果并未表明 MEST 在缓解自我报告的抑郁症状方面优于 PSC。讨论了对 MEST 的后期确定性试验的影响。