Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Center for Stress Research, Keio University, Tokyo, Japan.
Psychiatry Clin Neurosci. 2020 Feb;74(2):132-139. doi: 10.1111/pcn.12960. Epub 2019 Dec 20.
The primary objective of this study was to examine the effectiveness of mindfulness-based cognitive therapy (MBCT) in secondary-care settings where the vast majority of the patients have already undergone pharmacotherapy but have not remitted.
Eligible participants were aged between 20 and 75 years and met the criteria for panic disorder/agoraphobia or social anxiety disorder specified in the DSM-IV. They were randomly assigned to either the MBCT group (n = 20) or the wait-list control group (n = 20). The primary outcome was the difference in mean change scores between pre- and post-intervention assessments on the State-Trait Anxiety Inventory (STAI). The outcome was analyzed using an intent-to-treat approach and a mixed-effect model repeated measurement.
We observed significant differences in mean change scores for the STAI State Anxiety subscale (difference, -10.1; 95% confidence interval, -16.9 to -3.2; P < 0.005) and STAI Trait Anxiety subscale (difference, -11.7; 95% confidence interval, -17.0 to -6.4; P < 0.001) between the MBCT and control groups.
MBCT is effective in patients with anxiety disorders in secondary-care settings where the vast majority of patients are treatment-resistant to pharmacotherapy.
本研究的主要目的是检验正念认知疗法（MBCT）在二级医疗环境中的有效性，该环境中的绝大多数患者已经接受了药物治疗但未缓解。
符合条件的参与者年龄在 20 至 75 岁之间，符合 DSM-IV 中规定的惊恐障碍/广场恐怖症或社交焦虑症的标准。他们被随机分配到 MBCT 组（n=20）或候补名单对照组（n=20）。主要结果是状态特质焦虑量表（STAI）在干预前后评估之间的平均变化分数差异。使用意向治疗方法和混合效应模型重复测量分析结果。
我们观察到 STAI 状态焦虑分量表的平均变化分数存在显著差异（差异，-10.1；95%置信区间，-16.9 至 -3.2；P<0.005）和 STAI 特质焦虑分量表（差异，-11.7；95%置信区间，-17.0 至 -6.4；P<0.001）在 MBCT 和对照组之间。
MBCT 对二级医疗环境中大多数对药物治疗有抗药性的焦虑症患者有效。
