认知行为疗法对重度抑郁症患者未来思维的影响：一项随机对照试验。

The effect of cognitive behavioral therapy on future thinking in patients with major depressive disorder: A randomized controlled trial.

作者信息

Amano Mizuki, Katayama Nariko, Umeda Satoshi, Terasawa Yuri, Tabuchi Hajime, Kikuchi Toshiaki, Abe Takayuki, Mimura Masaru, Nakagawa Atsuo

机构信息

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.

Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan.

出版信息

Front Psychiatry. 2023 Jan 25;14:997154. doi: 10.3389/fpsyt.2023.997154. eCollection 2023.

DOI:10.3389/fpsyt.2023.997154

PMID:36761867

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9905738/

Abstract

BACKGROUND

Pessimistic thinking about the future is one of the cardinal symptoms of major depression. Few studies have assessed changes in pessimistic thinking after undergoing cognitive behavioral therapy (CBT). A randomized clinical trial (RCT) was conducted with patients diagnosed with major depressive disorder (MDD) to determine whether receiving a course of CBT affects pessimistic future thinking using a future thinking task.

METHODS

Thirty-one patients with MDD were randomly assigned to either CBT ( = 16) or a talking control (TC) ( = 15) for a 16-week intervention. The main outcomes were the change in response time (RT) and the ratio of the responses for positive valence, measured by the future thinking task. Secondary outcomes included the GRID-Hamilton Depression Rating Scale, the Beck Depression Inventory-Second Edition (BDI-II), the Dysfunctional Attitude Scale (DAS), and the word fluency test (WFT).

RESULTS

Regarding the main outcomes, the CBT group showed reduced RT for the positive valence (within-group Cohen's = 0.7, = 0.012) and negative valence (within-group Cohen's = 0.6, = 0.03) in the distant future condition. The ratio of positive valence responses in both groups for all temporal conditions except for the distant past condition increased within group (distant future: CBT: Cohen's = 0.5, = 0.04; TC: Cohen's = 0.8, = 0.008; near future: CBT: Cohen's = 1.0, < 0.001; TC: Cohen's = 1.1, = 0.001; near past: CBT: Cohen's = 0.8, = 0.005; TC: Cohen's = 1.0, = 0.002). As for secondary outcomes, the CBT group showed greater improvement than the TC group regarding the need for social approval as measured by the DAS ( = 0.012).

CONCLUSION

Patients with MDD who received CBT showed a reduced RT for the positive and negative valence in the distant future condition. RT in the future thinking task for depressed patients may be a potential objective measure for the CBT treatment process. Because the present RCT is positioned as a pilot RCT, a confirmatory trial with a larger number of patients is warranted to elucidate the CBT treatment process that influences future thinking.

CLINICAL TRIAL REGISTRATION

https://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000021028, identifier UMIN000018155.

摘要

背景

对未来的消极思维是重度抑郁症的主要症状之一。很少有研究评估认知行为疗法（CBT）后消极思维的变化。对诊断为重度抑郁症（MDD）的患者进行了一项随机临床试验（RCT），以确定接受一个疗程的CBT是否会使用未来思维任务影响对未来的消极思维。

方法

31例MDD患者被随机分配到CBT组（n = 16）或谈话对照组（TC）（n = 15）进行为期16周的干预。主要结局是通过未来思维任务测量的反应时间（RT）变化和积极效价反应的比例。次要结局包括汉密尔顿抑郁量表（GRID-Hamilton）、贝克抑郁量表第二版（BDI-II）、功能失调性态度量表（DAS）和词语流畅性测试（WFT）。

结果

关于主要结局，CBT组在遥远未来条件下积极效价的RT降低（组内Cohen's d = 0.7，p = 0.012），消极效价的RT降低（组内Cohen's d = 0.6，p = 0.03）。除遥远过去条件外，两组在所有时间条件下积极效价反应的比例均在组内增加（遥远未来：CBT：Cohen's d = 0.5，p = 0.04；TC：Cohen's d = 0.8，p = 0.008；近期未来：CBT：Cohen's d = 1.0，p < 0.001；TC：Cohen's d = 1.1，p = 0.001；近期过去：CBT：Cohen's d = 0.8，p = 0.005；TC：Cohen's d = 1.0，p = 0.002）。至于次要结局，CBT组在DAS测量的社会认可需求方面比TC组有更大改善（p = 0.012）。