Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand.
Specialist Mental Health Services, Canterbury District Health Board, Christchurch, New Zealand.
BMC Psychiatry. 2019 Feb 1;19(1):52. doi: 10.1186/s12888-019-2038-2.
Inpatients with depression have a poor long term outcome with high rates of suicide, high levels of morbidity and frequent re-admission. Current treatment often relies on pharmacological intervention and focuses on observation to maintain safety. There is significant neurocognitive deficit which is linked to poor functional outcomes. As a consequence, there is a need for novel psychotherapeutic interventions that seek to address these concerns.
We combined cognitive activation and behavioural activation to create activation therapy (AT) for the treatment of inpatient depression and conducted a small open label study which demonstrated acceptability and feasibility. We propose a randomised controlled trial which will compare treatment as usual (TAU) with TAU plus activation therapy for adult inpatients with a major depressive episode. The behavioural activation component involves therapist guided re-engagement with previously or potentially rewarding activities. The cognitive activation aspect utilises computer based exercises which have been shown to improve cognitive function.
The proposed randomised controlled trial will examine whether or not the addition of this therapy to TAU will result in a reduced re-hospitalisation rate at 12 weeks post discharge. Subjective change in activation and objectively measured change in activity levels will be rated, and the extent of change to neurocognition will be assessed.
Unique trial number: U1111-1190-9517. Australian New Zealand Clinical Trials Registry (ANZCTR) number: ACTRN12617000024347p .
抑郁症住院患者的长期预后较差，自杀率高、发病率高、频繁再入院。目前的治疗往往依赖于药物干预，并侧重于观察以维持安全。存在明显的神经认知缺陷，这与不良的功能结果有关。因此，需要新的心理治疗干预措施来解决这些问题。
我们将认知激活和行为激活相结合，为住院抑郁症患者创建了激活治疗（AT），并进行了一项小型开放标签研究，该研究证明了其可接受性和可行性。我们提出了一项随机对照试验，将比较常规治疗（TAU）与 TAU 加激活治疗对有重度抑郁症发作的成年住院患者的疗效。行为激活部分涉及治疗师指导重新参与以前或潜在有回报的活动。认知激活方面利用计算机为基础的练习，这些练习已被证明可以改善认知功能。
拟议的随机对照试验将检验在 TAU 中加入这种治疗是否会降低出院后 12 周的再住院率。将评定激活的主观变化和活动水平的客观测量变化，以及认知功能的变化程度。
独特的试验编号：U1111-1190-9517。澳大利亚新西兰临床试验注册（ANZCTR）编号：ACTRN12617000024347p。
