Postdoctoral Researcher, Department of Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands; and Department of Clinical Psychology and Psychotherapy, University of Freiburg, Germany.
Assistant Professor, Department of Clinical Psychological Science, Maastricht University, The Netherlands.
Br J Psychiatry. 2020 Apr;216(4):222-230. doi: 10.1192/bjp.2019.265.
It is unclear what session frequency is most effective in cognitive-behavioural therapy (CBT) and interpersonal psychotherapy (IPT) for depression.
Compare the effects of once weekly and twice weekly sessions of CBT and IPT for depression.
We conducted a multicentre randomised trial from November 2014 through December 2017. We recruited 200 adults with depression across nine specialised mental health centres in the Netherlands. This study used a 2 × 2 factorial design, randomising patients to once or twice weekly sessions of CBT or IPT over 16-24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II at baseline, before session 1, and 2 weeks, 1, 2, 3, 4, 5 and 6 months after start of the intervention. Intention-to-treat analyses were conducted.
Compared with patients who received weekly sessions, patients who received twice weekly sessions showed a statistically significant decrease in depressive symptoms (estimated mean difference between weekly and twice weekly sessions at month 6: 3.85 points, difference in effect size d = 0.55), lower attrition rates (n = 16 compared with n = 32) and an increased rate of response (hazard ratio 1.48, 95% CI 1.00-2.18).
In clinical practice settings, delivery of twice weekly sessions of CBT and IPT for depression is a way to improve depression treatment outcomes.
在认知行为疗法（CBT）和人际心理治疗（IPT）治疗抑郁症中，哪种治疗频率最有效尚不清楚。
比较每周一次和每周两次 CBT 和 IPT 治疗抑郁症的效果。
我们于 2014 年 11 月至 2017 年 12 月进行了一项多中心随机试验。我们在荷兰 9 个专门的精神卫生中心招募了 200 名患有抑郁症的成年人。本研究采用 2×2 析因设计，将患者随机分为每周一次或两次 CBT 或 IPT 治疗，疗程为 16-24 周，最多 20 次。主要结局指标为抑郁严重程度，采用贝克抑郁量表第二版（Beck Depression Inventory-II）在基线、第 1 次治疗前、治疗开始后 2 周、1、2、3、4、5 和 6 个月进行测量。采用意向治疗分析。
与每周接受治疗的患者相比，每周接受两次治疗的患者抑郁症状明显减轻（6 个月时每周和每周两次治疗的估计平均差异：3.85 分，效应大小差异 d = 0.55），脱落率降低（n = 16 与 n = 32），应答率增加（风险比 1.48，95%置信区间 1.00-2.18）。
在临床实践环境中，提供每周两次的 CBT 和 IPT 治疗抑郁症是改善抑郁症治疗效果的一种方法。
