King Juan Carlos University, Department of Psychology, Alcorcón, Spain.
Autonomous University of Madrid, Department of Biological and Health Psychology, Madrid, Spain.
J Alzheimers Dis. 2021;83(1):395-405. doi: 10.3233/JAD-210348.
While most intervention studies conducted with dementia family caregivers have focused on depressive symptoms as the main outcome, no study has analyzed the effects of an intervention on comorbid clinical presentations of depressive and anxious symptomatology.
The aim of this study was to examine the association between clinical depressive and anxious symptomatology at baseline and treatment responses of dementia family caregivers using samples from two randomized intervention trials with the same pre-post design.
Specifically, the effects on depressive and anxious comorbidity of three intervention conditions (Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and a control group (CG)) were analyzed. Participants were 130 dementia family caregivers. In addition to sociodemographic variables, depressive and anxious symptomatology were measured.
Caregivers with clinical depressive and anxiety comorbid symptoms at baseline recovered less well from depressive symptoms after CBT (45.45%) and ACT (47.72%) interventions than caregivers with non-comorbidity (100% recovery in both treatments). No significant association between comorbidity and treatment responses on depression was found for the control group. Regarding anxiety, among participants with comorbidity at baseline, 36.36% of caregivers in CBT and 30.9 % in the ACT group recovered from anxiety symptoms after treatment, compared to 6.45% in the control group. Similar results were obtained regarding those caregivers who recovered both from clinical depressive and anxiety symptoms and showed comorbidity at baseline.
Caregivers that show comorbid depressive and anxiety symptoms at baseline may benefit less from interventions than caregivers who do not show comorbidity.
虽然大多数针对痴呆症家庭照顾者的干预研究都将抑郁症状作为主要结果，但没有研究分析干预对抑郁和焦虑症状共病的临床表现的影响。
本研究旨在使用两项具有相同前后设计的随机干预试验的样本，分析基线时临床抑郁和焦虑症状与痴呆症家庭照顾者治疗反应之间的关系。
具体而言，分析了三种干预条件（认知行为疗法（CBT）、接受与承诺疗法（ACT）和对照组（CG））对抑郁和焦虑共病的影响。参与者为 130 名痴呆症家庭照顾者。除了社会人口统计学变量外，还测量了抑郁和焦虑症状。
基线时有临床抑郁和焦虑共病症状的照顾者在 CBT（45.45%）和 ACT（47.72%）干预后从抑郁症状中恢复得较差，而非共病的照顾者（两种治疗均 100%恢复）。对照组未发现共病与抑郁治疗反应之间有显著关联。对于焦虑症，在基线时有共病的参与者中，CBT 组有 36.36%的照顾者和 ACT 组有 30.9%的照顾者在治疗后焦虑症状得到缓解，而对照组只有 6.45%。对于那些同时从临床抑郁和焦虑症状中恢复并在基线时表现出共病的照顾者，也得到了类似的结果。
与没有共病的照顾者相比，基线时表现出抑郁和焦虑共病症状的照顾者可能从干预中获益较少。
