Center for Primary Health Care Research, Lund University, Clinical Research Centre (CRC), Malmö, Sweden.
Early Interv Psychiatry. 2019 Aug;13(4):943-952. doi: 10.1111/eip.12715. Epub 2018 Jul 3.
Although mindfulness-based group therapies (MGTs) for depressive, anxiety or stress and adjustment disorders are promising, there is a substantial lack of knowledge regarding the long-term improvements after such therapies in these common psychiatric disorders.
Two hundred and fifteen patients were randomized in a randomized clinical trial (RCT) (ClinicalTrials.gov ID: NCT01476371) conducted in 2012 at 16 primary healthcare centres in southern Sweden. The patients were randomized to MGT or treatment as usual (TAU) and completed four psychometric self-rated scales after 8 weeks of treatment. Approximately 12 months after the completion of the 8-week treatment, the same scales were repeated. Ordinal and generalized linear-mixed models, adjusted for cluster effects, were used for the analysis.
For all four psychometric scales (MADRS-S [Montgomery-Åsberg Depression Rating Scale-S], HADS-D, HADS-A [Hospital Anxiety and Depression Scale A and D] and PHQ-9 [Patient Health Questionnaire-9]) the scores at the 1-year follow-up were significantly improved (all P values <0.001) in both groups. Furthermore, there were no significant differences between the MGT and TAU in the psychometric scores at the 1-year follow-up.
To the best of our knowledge, this is the first RCT comparing the long-term improvements after MGT with TAU. Although it cannot be excluded that our findings are a result of the natural course of common psychiatric disorders or other factors, they suggest a long-term positive improvement after both MGT and TAU.
尽管基于正念的团体疗法(MGT)在治疗抑郁、焦虑或压力和适应障碍方面很有前景,但对于这些常见精神障碍在这种治疗后的长期改善,我们知之甚少。
2012 年,在瑞典南部的 16 个初级保健中心进行了一项随机临床试验(RCT)(ClinicalTrials.gov 编号:NCT01476371),共有 215 名患者参与随机分组,分为 MGT 组或常规治疗组(TAU)。患者在接受 8 周治疗后完成了 4 项心理自评量表。大约在 8 周治疗结束后 12 个月,重复使用相同的量表。采用有序和广义线性混合模型,对聚类效应进行调整,进行分析。
对于所有 4 项心理量表(MADRS-S [蒙哥马利-Åsberg 抑郁评定量表-S]、HADS-D、HADS-A [医院焦虑和抑郁量表 A 和 D] 和 PHQ-9 [患者健康问卷-9]),两组患者在 1 年随访时的评分均有显著改善(所有 P 值均<0.001)。此外,MGT 组和 TAU 组在 1 年随访时的心理评分无显著差异。
据我们所知,这是首次比较 MGT 与 TAU 后长期改善的 RCT。尽管不能排除我们的发现是常见精神障碍自然病程或其他因素的结果,但它们表明 MGT 和 TAU 后都有长期的积极改善。