基于正念的认知疗法对伴有抑郁和焦虑的老年人应激与炎症外周标志物的影响:一项随机对照试验的平行分析

Effects of Mindfulness-Based Cognitive Therapy on Peripheral Markers of Stress and Inflammation in Older-Adults With Depression and Anxiety: A Parallel Analysis of a Randomized Controlled Trial.

作者信息

Belliveau Claudia, Nagy Corina, Escobar Sophia, Mechawar Naguib, Turecki Gustavo, Rej Soham, Torres-Platas Susana G

机构信息

McGill Group for Suicide Studies (MGSS), Douglas Mental Health University Institute, Montreal, QC, Canada.

Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.

出版信息

Front Psychiatry. 2021 Dec 24;12:804269. doi: 10.3389/fpsyt.2021.804269. eCollection 2021.

Abstract

Depression and anxiety are prevalent in older-adults and often difficult to treat: up to 55% of patients are unresponsive to pharmacotherapy. Mindfulness-Based Cognitive Therapy (MBCT) is a promising treatment, however, its biological mechanisms remain unknown in older-adults. We examined if, in older-adults, decreased depression and anxiety symptoms after MBCT are associated with changes in the expression levels of C-reactive protein, Interleukin-1β, Monocyte chemoattractant protein-1 and mineralocorticoid receptor compared to treatment as usual (TAU). Older-adults (age ≥60) with depression and anxiety were randomized to MBCT or treatment as usual. Gene expression levels from blood samples were measured using quantitative polymerase chain reaction ( = 37) at baseline and after 8-weeks of MBCT or TAU. As previously published, we found a significant reduction in symptoms of depression F (1, 35) = 10.68, = 0.002, partial η = 0.23 and anxiety F (1, 35) = 9.36, = 0.004, partial η = 0.21 in geriatric participants following MBCT compared to TAU. However, the expression levels of measured genes were not significantly different between groups and were not associated with changes in depression and anxiety symptoms. Our results suggest that the symptom reduction following MBCT in older-adults may not be accompanied by changes in the stress-response and inflammatory pathways. Future research should address other potential biological alterations associated to MBCT that may be responsible for the reduction of symptoms.

摘要

抑郁症和焦虑症在老年人中很普遍,且往往难以治疗:高达55%的患者对药物治疗无反应。基于正念的认知疗法(MBCT)是一种很有前景的治疗方法,然而,其在老年人中的生物学机制尚不清楚。我们研究了在老年人中,与常规治疗(TAU)相比,MBCT后抑郁和焦虑症状的减轻是否与C反应蛋白、白细胞介素-1β、单核细胞趋化蛋白-1和盐皮质激素受体表达水平的变化有关。患有抑郁和焦虑症的老年人(年龄≥60岁)被随机分为接受MBCT或常规治疗。在基线以及接受8周的MBCT或TAU治疗后,使用定量聚合酶链反应(n = 37)测量血样中的基因表达水平。正如之前发表的那样,我们发现与TAU相比,老年参与者在接受MBCT后抑郁症状F(1, 35)= 10.68,p = 0.002,偏η² = 0.23和焦虑症状F(1, 35)= 9.36,p = 0.004,偏η² = 0.21有显著降低。然而,测量基因的表达水平在两组之间没有显著差异,并且与抑郁和焦虑症状的变化无关。我们的结果表明,老年人接受MBCT后症状减轻可能不会伴随着应激反应和炎症途径的变化。未来的研究应该探讨与MBCT相关的其他潜在生物学改变,这些改变可能是症状减轻的原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a03e/8739479/cda8102ff767/fpsyt-12-804269-g0001.jpg

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