Department of Clinical Psychology, University of Oslo, Oslo, Norway.
Research Institute, Modum Bad Psychiatric Center, Oslo, Norway.
Acta Neuropsychiatr. 2021 Apr;33(2):65-71. doi: 10.1017/neu.2020.38. Epub 2020 Oct 28.
Psychotherapy research aims to investigate predictors and moderators of treatment outcome, but there are few consistent findings. This study aimed to investigate cytokines in patients undergoing treatment for anxiety disorders and whether the level of cytokines moderated the treatment outcome. Thirty-seven patients with comorbid and treatment-resistant anxiety disorders were investigated using multilevel modelling. Serum cytokine levels were measured three times: pretreatment, in the middle of treatment, and at the end of treatment. Anxiety and metacognitions were measured weekly throughout treatment by self-report. The levels of monocyte chemoattractant protein-1, tumour necrosis factor-alpha, and interleukin-1 receptor antagonist did not change during therapy or were not related to the level of anxiety. Metacognitive beliefs predicted anxiety, but the relationship between metacognitions and anxiety was not moderated by cytokines. Limitations of the study include that the patients were not fasting at blood sampling, and we did not assess body mass index, which may affect cytokine levels. The lack of significance for cytokines as a predictor or moderator may be due to a lack of power for testing moderation hypotheses, a problem associated with many psychotherapy studies. Cytokines did not predict the outcome in the treatment of comorbid anxiety disorders in our sample. Furthermore, cytokines did not moderate the relationship between metacognitions and anxiety.
心理治疗研究旨在探讨治疗结果的预测因素和调节因素，但很少有一致的发现。本研究旨在调查焦虑障碍患者治疗过程中的细胞因子，以及细胞因子的水平是否调节治疗结果。使用多层次模型对 37 名伴有共病和治疗抵抗的焦虑障碍患者进行了调查。在治疗前、治疗中期和治疗结束时三次测量血清细胞因子水平。焦虑和元认知通过自我报告每周在整个治疗过程中进行测量。在治疗过程中，单核细胞趋化蛋白-1、肿瘤坏死因子-α和白细胞介素-1 受体拮抗剂的水平没有变化，或者与焦虑水平无关。元认知信念预测焦虑，但元认知与焦虑之间的关系不受细胞因子的调节。研究的局限性包括采血时患者未禁食，并且我们没有评估体重指数，这可能会影响细胞因子水平。细胞因子作为预测因子或调节剂的意义不大，可能是由于检验调节假设的能力不足所致，这是许多心理治疗研究中存在的问题。在我们的样本中，细胞因子并未预测共病焦虑障碍的治疗结果。此外，细胞因子并未调节元认知与焦虑之间的关系。
