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双相抑郁症患者的积极心理学干预:一项随机试点试验。

A positive psychology intervention for patients with bipolar depression: a randomized pilot trial.

机构信息

Harvard Medical School, Boston, MA, USA.

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

出版信息

J Ment Health. 2020 Feb;29(1):60-68. doi: 10.1080/09638237.2018.1521942. Epub 2018 Oct 26.

Abstract

There are few effective treatments for bipolar depression, a common and debilitating illness. We aimed to examine the feasibility and preliminary efficacy of a four-week, telephone-delivered positive psychology (PP) intervention for patients with bipolar depression. Twenty-five patients hospitalized for bipolar depression were randomized to receive a PP ( = 14) or control condition (CC;  = 11) intervention. Following discharge, participants completed weekly exercises and phone calls with a study trainer. PP intervention feasibility was assessed by the number of exercises completed, and acceptability was examined on five-point Likert-type scales of ease and utility. Between-group differences on psychological constructs at 4 and 8 weeks post-enrollment were assessed using mixed effects regression models. Participants in the PP group completed an average of three out of four PP exercises and found PP exercises to be subjectively helpful, though neither easy nor difficult. Compared to CC, the PP intervention led to trends towards greater improvements in positive affect and optimism at follow-up, with large effect sizes (modified Cohen's  = 0.95-1.24). PP had variable, non-significant effects on negative psychological constructs. Larger, randomized trials are needed to further evaluate the efficacy of this intervention in this high-risk population.

摘要

对于双相情感障碍的抑郁症,这是一种常见且使人虚弱的疾病,目前几乎没有有效的治疗方法。我们旨在研究为期四周的电话传递积极心理学(PP)干预对双相情感障碍抑郁症患者的可行性和初步疗效。25 名因双相情感障碍住院的患者被随机分配接受 PP(n=14)或对照组(CC;n=11)干预。出院后,参与者每周完成练习并与研究培训师进行电话交流。通过完成的练习数量评估 PP 干预的可行性,并使用五点李克特量表评估易用性和实用性来评估可接受性。使用混合效应回归模型评估 4 周和 8 周后心理结构的组间差异。PP 组的参与者平均完成了四分之三的 PP 练习,他们认为 PP 练习主观上有帮助,但既不难也不简单。与 CC 相比,PP 干预在随访时表现出积极情绪和乐观主义的趋势更大,具有较大的效应量(修正后的 Cohen's  = 0.95-1.24)。PP 对消极心理结构的影响则各不相同,且无统计学意义。需要更大规模的随机试验来进一步评估该干预措施在这一高风险人群中的疗效。

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