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正念认知疗法联合药物治疗对康复期重度抑郁症患者预防复发的有效性。

The effectiveness of mindfulness-based cognitive therapy combined with medication therapy in preventing recurrence of major depressive disorder in convalescent patients.

作者信息

Guo Hui-Rong, Wang Jun-Ru, Wang Ya-Li, Huang Bai-Ling, Yang Xu-Huan, Ren Yu-Ming

机构信息

Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Psychiatry, People's Hospital of Zhengzhou, Zhengzhou, China.

出版信息

Front Psychol. 2022 Aug 18;13:882006. doi: 10.3389/fpsyg.2022.882006. eCollection 2022.

Abstract

OBJECTIVE

This study aims to investigate the effectiveness of mindfulness-based cognitive therapy (MBCT) combined with medication therapy in preventing the recurrence of major depressive disorder (MDD) in convalescent patients.

METHODS

A total of 130 patients with convalescent MDD were enrolled in this prospective study. Sixty-five patients were assigned to the experimental group and received medication therapy combined with MBCT, and 65 patients were assigned to the control group and treated with medication alone. The recurrence rate and related hormonal changes were compared between the two groups.

RESULTS

After 1 year of MBCT intervention, eight patients experienced recurrence in the experimental group, a recurrence rate of 12.31%, and 19 patients experienced recurrence in the control group, a recurrence rate of 29.23%. The Hamilton Depression Rating Scale (HAM-D) and the World Health Organization Quality of Life Scale (WHOQOL-BREF) scores in both the experimental and the control groups were significantly improved after treatment ( < 0.05). The difference in the HAM-D scores before and after treatment in the experimental group was 16.74 ± 4.54; this was significantly higher than that of the control group (8 ± 3.89, < 0.0001). The WHOQOL-BREF scores in the experimental group were significantly improved compared with those of the control group ( < 0.0001). The differences in the levels of corticotrophin-releasing hormone (CRH), adrenocorticotropic hormone, and cortisol before and after treatment in the experimental group and the control group were statistically significant ( < 0.05). The difference in CRH before and after treatment in the experimental group was 16.8 ± 7.2, which was higher than that of the control group (2.75 ± 9.27, < 0.0001). The intervention with MBCT had a significant impact on the recurrence of MDD [β = 1.206, = 0.039, 95% (confidence interval) CI = 0.0790-1.229]. The difference in the HAM-D scores also had a significant impact on the recurrence of MDD (β = 1.121, = 0.0014, 95% CI = 0.805-0.976).

CONCLUSION

Compared with medication therapy alone, the use of MBCT combined with medication therapy can effectively prevent the recurrence of MDD in convalescent patients.

摘要

目的

本研究旨在探讨正念认知疗法(MBCT)联合药物治疗对康复期重度抑郁症(MDD)患者预防复发的有效性。

方法

本前瞻性研究共纳入130例康复期MDD患者。65例患者被分配到实验组,接受药物治疗联合MBCT,65例患者被分配到对照组,仅接受药物治疗。比较两组的复发率及相关激素变化。

结果

MBCT干预1年后,实验组有8例患者复发,复发率为12.31%,对照组有19例患者复发,复发率为29.23%。治疗后实验组和对照组的汉密尔顿抑郁量表(HAM-D)及世界卫生组织生活质量量表(WHOQOL-BREF)评分均显著改善(<0.05)。实验组治疗前后HAM-D评分差值为16.74±4.54;显著高于对照组(8±3.89,<0.0001)。实验组WHOQOL-BREF评分与对照组相比显著改善(<0.0001)。实验组和对照组治疗前后促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素及皮质醇水平的差异有统计学意义(<0.05)。实验组治疗前后CRH差值为16.8±7.2,高于对照组(2.75±9.27,<0.0001)。MBCT干预对MDD复发有显著影响[β=1.206,=0.039,95%(置信区间)CI=0.0790-1.229]。HAM-D评分差值对MDD复发也有显著影响(β=1.121,=0.0014,95%CI=0.805-0.976)。

结论

与单纯药物治疗相比,MBCT联合药物治疗可有效预防康复期MDD患者复发。

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