Stevanovic Dejan, Zalsman Gil
a Clinic for Neurology and Psychiatry for Children and Youth , Belgrade , Serbia.
b Division of Child and Adolescent Psychiatry , Geha Mental Health Center , Petah Tikva , Israel.
Cogn Neuropsychiatry. 2019 Jan;24(1):4-13. doi: 10.1080/13546805.2018.1532284. Epub 2018 Oct 11.
It is supposed that both antidepressants and psychotherapies work in a manner consistent with cognitive theories of depression when changing negative affective and cognitive distortions. This study evaluated changes in cognitive distortions (i.e. systematic misinterpretations of new information) and affectivity in adolescent major depressive disorder (MDD) after acute phase treatment with fluoxetine.
Twenty-five adolescents (mean age 15.10 years (SD = 1.19); 17 (68%) females) with MDD receiving fluoxetine were followed for 8 weeks. Clinician rating scales of MDD and self-reports of cognitive distortions and affectivity were completed before and after the treatment.
Seven (28%) adolescents showed significant improvement in cognitive distortions, 11 (44%) showed a significant decrease in negative affect, and 15 (60%) showed a significant increase in positive affect. The responders to fluoxetine had significantly decreased level of negative affect (62.5%) and an increased level in positive affect (81.2%) compared to non-responders, whereas there were no differences between the two regarding changes in cognitive distortions.
Treatment with fluoxetine over 8 weeks led to reductions in cognitive distortions, with decreased negative and increased positive affect in adolescents with MDD. Improvements in affectivity levels closely corresponded to reductions in depressive symptoms and were greater than improvements in cognitive distortions.
据推测,抗抑郁药和心理治疗在改变负面情绪和认知扭曲时,其作用方式与抑郁症的认知理论相一致。本研究评估了氟西汀急性期治疗后青少年重度抑郁症(MDD)患者认知扭曲(即对新信息的系统性错误解读)和情感的变化。
对25名接受氟西汀治疗的青少年MDD患者(平均年龄15.10岁(标准差=1.19);17名(68%)为女性)进行了为期8周的随访。在治疗前后完成了MDD的临床评定量表以及认知扭曲和情感的自我报告。
7名(28%)青少年的认知扭曲有显著改善,11名(44%)的负面情绪显著降低,15名(60%)的正面情绪显著增加。与无反应者相比,氟西汀治疗有反应者的负面情绪水平显著降低(62.5%),正面情绪水平升高(81.2%),而两者在认知扭曲变化方面没有差异。
氟西汀治疗8周可减少青少年MDD患者的认知扭曲,同时降低负面情绪并增加正面情绪。情感水平的改善与抑郁症状的减轻密切相关,且大于认知扭曲的改善。