Luttenberger Katharina, Donath Carolin, Graessel Elmar, Kornhuber Johannes, Schlüter Annika, Dorscht Lisa, Kind Leona
Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Clin Psychol Psychother. 2023 Aug 29. doi: 10.1002/cpp.2898.
Bouldering psychotherapy (BPT) for depression has proven effective, but nothing is known about its potential predictors of response. This study should identify predictors of response to BPT, cognitive behavioural therapy (CBT) and an active control (home-based exercise programme; EP) using a literature-based model.
In a multicentre randomised controlled trial, 233 outpatients were assigned to BPT, CBT or EP. Response (reduction of at least 46% on the Montgomery-Åsberg Depression Rating Scale [MADRS]) and remission (≤7 MADRS points) were defined as suggested by the literature. Predictors of response were identified twofold: (1) univariate analyses followed by logistic regression analyses in each group with all predictors yielding a univariate p-value <.20 and (2) a backward regression analysis with all potential predictors. Only variables that emerged as predictors in both types of analyses were interpreted.
There was a significantly greater proportion of responders (p = .035) in the BPT than in the EP. The chance of response in the BPT was higher for patients with a higher health-related quality of life. In the EP, response was higher for patients with lower interpersonal sensitivity, suffering from their first episode and living with a partner.
Response rates in BPT are similar to or even higher than in other outpatient psychotherapy group therapies. BPT and CBT are suitable for a wide range of patients, but patients with higher functionality could start with psychoeducation and exercise.
已有研究证明，抱石心理疗法（BPT）治疗抑郁症有效，但对其反应的潜在预测因素尚不清楚。本研究旨在使用基于文献的模型，确定BPT、认知行为疗法（CBT）和积极对照（家庭锻炼计划；EP）反应的预测因素。
在一项多中心随机对照试验中，233名门诊患者被分配接受BPT、CBT或EP治疗。反应（蒙哥马利-阿斯伯格抑郁量表[MADRS]评分至少降低46%）和缓解（MADRS评分≤7分）的定义如文献所述。反应的预测因素通过两种方式确定：（1）单因素分析，然后在每组中对所有单因素p值<.20的预测因素进行逻辑回归分析；（2）对所有潜在预测因素进行向后回归分析。只有在两种分析中均作为预测因素出现的变量才进行解释。
BPT组的反应者比例显著高于EP组（p = 0.035）。健康相关生活质量较高的患者接受BPT治疗时反应的可能性更高。在EP组中，人际敏感性较低、首次发作且与伴侣同住的患者反应较高。
BPT的反应率与其他门诊心理治疗团体疗法相似，甚至更高。BPT和CBT适用于广泛的患者，但功能较高的患者可以从心理教育和锻炼开始。
