Lemmens Lotte H J M, van Bronswijk Suzanne C, Peeters Frenk P M L, Arntz Arnoud, Roefs Anne, Hollon Steven D, DeRubeis Robert J, Huibers Marcus J H
Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands (Lemmens, van Bronswijk, Peeters, Roefs); Department of Clinical Psychology, University of Amsterdam, Amsterdam (Arntz); Department of Psychology, Vanderbilt University, Nashville, Tennessee (Hollon); Department of Psychology, University of Pennsylvania, Philadelphia (DeRubeis, Huibers); Department of Clinical Psychology, VU University Amsterdam, Amsterdam (DeRubeis, Huibers).
Am J Psychother. 2020 Mar 1;73(1):8-14. doi: 10.1176/appi.psychotherapy.20190030. Epub 2020 Mar 3.
Although the effectiveness of interpersonal psychotherapy (IPT) and cognitive therapy (CT) for major depression has been established, little is known about how and for whom they work and how they compare in the long term. The latter is especially relevant for IPT because research on its long-term effects has been limited. This overview paper summarizes findings from a Dutch randomized controlled trial on the effects and mechanisms of change of IPT versus CT for major depression.
Adult outpatients with depression (N=182) were randomly assigned to CT (N=76), IPT (N=75), or a 2-month waitlist control group followed by patient's treatment of choice (N=31). The primary outcome was depression severity. Other outcomes were quality of life, social and general psychological functioning, and scores on various mechanism measures. Interventions were compared at the end of treatment and up to 17 months follow-up.
On average, IPT and CT were both superior to waitlist, and their outcomes did not differ significantly from one another. However, the pathway through which change occurred appeared to differ. For a majority of participants, one of the interventions was predicted to be more beneficial than the other. No support for the theoretical models of change was found.
Outcomes of IPT and CT did not appear to differ significantly. IPT may have an enduring effect not different from that of CT. The field would benefit from further refinement of study methods to disentangle mechanisms of change and from advances in the field of personalized medicine (i.e., person-specific analyses and treatment selection methods).
虽然人际心理治疗（IPT）和认知疗法（CT）对重度抑郁症的有效性已得到证实，但对于它们如何发挥作用、对哪些人有效以及长期效果对比情况却知之甚少。后者对IPT尤为重要，因为关于其长期效果的研究有限。这篇综述性论文总结了一项荷兰随机对照试验的结果，该试验旨在研究IPT与CT治疗重度抑郁症的效果及变化机制。
成年抑郁症门诊患者（N = 182）被随机分配至CT组（N = 76）、IPT组（N = 75）或为期2个月的等待列表对照组，之后由患者选择治疗方式（N = 31）。主要结局指标为抑郁严重程度。其他结局指标包括生活质量、社交及一般心理功能，以及各项机制测量指标的得分。在治疗结束时及长达17个月的随访期内对干预措施进行比较。
平均而言，IPT和CT均优于等待列表对照组，且它们的结局并无显著差异。然而，发生改变的途径似乎有所不同。对于大多数参与者来说，预计其中一种干预措施比另一种更有益。未发现对改变理论模型的支持。
IPT和CT的结局似乎无显著差异。IPT可能具有与CT无异的持久效果。该领域将受益于进一步完善研究方法以厘清改变机制，以及受益于个性化医疗领域的进展（即针对个体的分析和治疗选择方法）。
