Sürig Svenja, Ohm Katharina, Grave Ulrike, Glanert Sarah, Herzog Philipp, Fassbinder Eva, Borgwardt Stefan, Klein Jan Philipp
Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.
Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Germany.
Front Psychiatry. 2021 Aug 16;12:619674. doi: 10.3389/fpsyt.2021.619674. eCollection 2021.
Interpersonal skills deficits and dysfunctional metacognitive beliefs have been implicated in the etiology and maintenance of depression. This study aimed to investigate the association between changes in these skills deficits and change in depressive symptoms over the course of treatment with Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and Metacognitive Therapy (MCT). In this prospective, parallel group observational study, data was collected at baseline and after 8 weeks of an intensive day clinic psychotherapy program. Based on a shared decision between patients and clinicians, patients received either CBASP or MCT. Ninety patients were included in the analyses (CBASP: age = 38.7, 40.5% female, MCT: age = 44.7, 43.3% female). Interpersonal deficits were assessed with the short-form of the Luebeck Questionnaire for Recording Preoperational Thinking (LQPT-SF) and the Impact Message Inventory (IMI-R). Metacognitive beliefs were assessed with the Metacognition Questionnaire-30 (MCQ-30). The Quick Inventory of Depressive Symptomatology (QIDS-SR16) was utilized to assess depressive symptoms. A regression analysis was conducted to assess variables associated with outcome. ANCOVAs were utilized to investigate whether improvement in skills deficits is dependent on type of treatment received. Improvements in preoperational thinking and increases in friendly-dominant behavior were associated with change in depressive symptoms. There was no association between reductions in dysfunctional metacognitive beliefs and a decrease in depressive symptoms. While both treatment groups showed significant improvements in interpersonal and metacognitive skills, there was no significant between-group difference in the change scores for either of these skills. Our findings suggest that changes in interpersonal skills seem to be of particular relevance in the treatment of depression. These results have to be replicated in a randomized-controlled design before firm conclusions can be drawn.
人际交往技能缺陷和功能失调的元认知信念与抑郁症的病因及维持有关。本研究旨在调查在认知行为分析心理治疗系统（CBASP）和元认知治疗（MCT）的治疗过程中，这些技能缺陷的变化与抑郁症状变化之间的关联。在这项前瞻性平行组观察性研究中，在基线时以及强化日间门诊心理治疗项目8周后收集数据。根据患者与临床医生的共同决定，患者接受CBASP或MCT治疗。90名患者纳入分析（CBASP组：年龄 = 38.7岁，女性占40.5%；MCT组：年龄 = 44.7岁，女性占43.3%）。使用吕贝克前运算思维记录问卷简版（LQPT-SF）和影响信息量表（IMI-R）评估人际交往缺陷。使用元认知问卷-30（MCQ-30）评估元认知信念。使用抑郁症状快速清单（QIDS-SR16）评估抑郁症状。进行回归分析以评估与结果相关的变量。使用协方差分析研究技能缺陷的改善是否取决于所接受的治疗类型。前运算思维的改善和友好主导行为的增加与抑郁症状的变化相关。功能失调的元认知信念的减少与抑郁症状的减轻之间没有关联。虽然两个治疗组在人际交往和元认知技能方面均有显著改善，但这些技能的变化分数在组间没有显著差异。我们的研究结果表明，人际交往技能的变化在抑郁症治疗中似乎特别重要。在得出确切结论之前，这些结果必须在随机对照设计中进行重复验证。
