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将光明带入黑暗:增强型抑郁治疗(ADepT)的多基线混合方法病例系列评估。

Bringing light into darkness: A multiple baseline mixed methods case series evaluation of Augmented Depression Therapy (ADepT).

机构信息

Mood Disorders Centre, University of Exeter, UK.

Mood Disorders Centre, University of Exeter, UK.

出版信息

Behav Res Ther. 2019 Sep;120:103418. doi: 10.1016/j.brat.2019.103418. Epub 2019 Jun 27.

Abstract

Two core features of depression are elevations in negative valence system (NVS) functioning and reductions in positive valence system (PVS) functioning. Existing psychological treatments have focused on the NVS and neglected the PVS, which may contribute to sub-optimal outcomes. The present mixed methods multiple randomised baseline case series preliminarily evaluates Augmented Depression Therapy (ADepT), a novel depression treatment targeting PVS and NVS disturbance, that aims both to reduce depression and enhance wellbeing. Eleven clinically depressed participants were recruited. Intensive time series analyses showed that 7/11 participants improved on both wellbeing and depression. Reliable and clinically significant improvement was observed for 9/11 participants on at least one of these outcomes (and also across a range of other PVS and NVS outcomes). Group level analyses showed significant pre to post change on all outcomes. Benchmarking analyses indicated these effect sizes were at least comparable (and for some PVS outcomes superior) to existing treatments. Gains were largely sustained over one-year follow-up. Qualitative interviews indicated ADepT was feasible and acceptable. These findings provide preliminary support for ADepT as a novel depression treatment. Further evaluation, directly comparing ADepT to existing treatments using randomised controlled trial designs, is now required.

摘要

抑郁症的两个核心特征是负效价系统(NVS)功能升高和正效价系统(PVS)功能降低。现有的心理治疗方法主要集中在 NVS 上,而忽略了 PVS,这可能导致治疗效果不佳。本混合方法多随机基线病例系列初步评估了增强型抑郁治疗(ADepT),这是一种针对 PVS 和 NVS 障碍的新型抑郁治疗方法,旨在降低抑郁程度和提高幸福感。招募了 11 名临床抑郁患者。密集的时间序列分析表明,7/11 名参与者在幸福感和抑郁方面都有所改善。9/11 名参与者在至少一项这些结果(以及其他一系列 PVS 和 NVS 结果)上观察到可靠且具有临床意义的改善。组水平分析表明所有结果均有显著的前后变化。基准分析表明,这些效果大小至少与现有治疗方法相当(对于某些 PVS 结果则更优)。在一年的随访中,收益基本保持稳定。定性访谈表明 ADepT 是可行且可接受的。这些发现为 ADepT 作为一种新型的抑郁症治疗方法提供了初步支持。现在需要使用随机对照试验设计直接比较 ADepT 与现有治疗方法的进一步评估。

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