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认知行为疗法对重性抑郁症患者言语学习和记忆的影响:一项随机对照试验的结果。

Effects of cognitive behavioural therapy on verbal learning and memory in major depression: Results of a randomized controlled trial.

机构信息

Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany.

Clinical Psychology and Psychotherapy, Medical School Berlin, Berlin, Germany.

出版信息

Clin Psychol Psychother. 2019 May;26(3):291-297. doi: 10.1002/cpp.2350. Epub 2019 Jan 20.

Abstract

Major depression (MD) is often accompanied by deficits in cognitive functioning. Cognitive behavioural therapy (CBT) has beneficial effects on MD. The aim of this study was to examine whether CBT affects verbal learning and memory in patients with MD and whether CBT that emphasizes exercise during behavioural activation has additional effects on verbal performance. Ninety-eight patients with MD were randomly assigned to CBT emphasizing either exercise during behavioural activation (CBT-E) or CBT emphasizing pleasurable low-energy activities (CBT-C). A passive waiting list control group was also involved (WL). Thirty nondepressed age- and sex-matched controls were included to examine potential verbal learning and memory alterations in MD at baseline. Neuropsychological measures were assessed at baseline and after 16 weeks of CBT and waiting time, respectively. Patients with MD demonstrated worse cognitive performance than healthy controls in verbal learning, recognition, and memory at baseline. After treatment, we found no improvements concerning verbal learning and memory performance compared with WL, with the exception of recognition memory. No differences were found between CBT conditions. Psychological treatments such as CBT seem to have limited influence on memory functions. Concerning recognition memory, our results contradict, in part, previous assumptions that cognitive impairments persists despite depressive symptom reduction.

摘要

重度抑郁症(MD)常伴有认知功能障碍。认知行为疗法(CBT)对 MD 有有益的影响。本研究旨在探讨 CBT 是否会影响 MD 患者的言语学习和记忆,以及强调行为激活过程中运动的 CBT 是否会对言语表现产生额外的影响。98 名 MD 患者被随机分配到强调行为激活过程中运动的 CBT-E 组或强调愉快低能量活动的 CBT-C 组。还包括一个被动等待名单对照组(WL)。为了在基线时检查 MD 中潜在的言语学习和记忆改变,我们纳入了 30 名无抑郁的年龄和性别匹配的对照组。神经心理学测试分别在基线、CBT 及等待时间的 16 周后进行评估。与健康对照组相比,MD 患者在言语学习、识别和记忆方面的认知表现较差。与 WL 相比,治疗后,我们发现言语学习和记忆表现没有改善,除了识别记忆。在 CBT 条件之间未发现差异。心理治疗,如 CBT,似乎对记忆功能的影响有限。关于识别记忆,我们的结果部分与先前的假设相矛盾,即尽管抑郁症状减轻,认知障碍仍然存在。

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