McGinn Lata K, Van Meter Anna, Kronish Ian, Gashin Jessica, Burns Karen, Kil Natalie, McGinn Thomas G
Ferkauf Graduate School of Psychology, Yeshiva University, Albert Einstein College of Medicine; 1165 Morris Park Avenue, Bronx, NY, 10461 USA.
Present Affiliation: The Feinstein Institute for Medical Research, The Zucker Hillside Hospital, Psychiatry Research, Glen Oaks, NY 11004.
Cognit Ther Res. 2019 Aug;43(4):679-692. doi: 10.1007/s10608-018-09990-7. Epub 2019 Feb 12.
Depression is the leading cause of disability and a major cause of morbidity worldwide, with societal costs now upwards of 1 trillion dollars across the globe. Hence, extending current efforts to augment prevention outcomes is consistent with global public health interests. Although many prevention programs have been developed and have demonstrated efficacy, studies have yet to demonstrate that CBT is effective in preventing symptoms in populations at risk for developing depression induced by pharmacological substances. Using a randomized, controlled design, this pilot study reports on the feasibility and preliminary effects of a novel, guided symptom exposure augmented cognitive behavioral prevention intervention (GSE-CBT) in a sample diagnosed with Hepatitis C at risk for developing medication induced depression. Results demonstrated that the guided symptom exposure augmented CBT (GSE-CBT) was feasible in this population and was delivered with high integrity. Although not statistically different, we observed a pattern of lower depression levels in the GSE-CBT group versus those in the control group throughout. This pilot study demonstrates that a psychosocial prevention intervention is feasible for use in patients at risk for developing pharmacologically induced depression and that a guided symptom exposure augmented CBT protocol has the potential to prevent symptoms of depression that develop as a side effect to taking these medications. Results are preliminary and future studies should use larger samples and test the intervention in other populations.
抑郁症是全球致残的主要原因和发病的主要原因，目前全球社会成本超过1万亿美元。因此，扩大目前增强预防效果的努力符合全球公共卫生利益。尽管已经制定了许多预防计划并证明了其有效性，但研究尚未证明认知行为疗法（CBT）在预防有因药物导致抑郁症风险的人群出现症状方面是有效的。本试点研究采用随机对照设计，报告了一种新型的、有指导的症状暴露增强认知行为预防干预措施（GSE-CBT）在被诊断为丙型肝炎且有药物性抑郁症风险的样本中的可行性和初步效果。结果表明，有指导的症状暴露增强认知行为疗法（GSE-CBT）在该人群中是可行的，并且实施具有高度完整性。尽管在统计学上没有差异，但我们观察到GSE-CBT组的抑郁水平在整个过程中低于对照组。这项试点研究表明，心理社会预防干预措施对于有药物性抑郁症风险的患者是可行的，并且有指导的症状暴露增强认知行为疗法方案有可能预防作为服用这些药物副作用而出现的抑郁症状。结果是初步的，未来的研究应该使用更大的样本并在其他人群中测试该干预措施。
