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常规认知疗法与认知疗法加记忆支持干预治疗抑郁症成人:一项随机对照试验的二次分析的 12 个月结果和提高疗效的机会。

Cognitive Therapy-as-Usual versus Cognitive Therapy plus the Memory Support Intervention for adults with depression: 12-month outcomes and opportunities for improved efficacy in a secondary analysis of a randomized controlled trial.

机构信息

University of California, 2121 Berkeley Way, Berkeley, CA, 94720, USA.

RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA.

出版信息

Behav Res Ther. 2023 Nov;170:104419. doi: 10.1016/j.brat.2023.104419. Epub 2023 Oct 10.

Abstract

OBJECTIVE

Patient memory for treatment is emerging as an important transdiagnostic mechanism of treatment outcomes. However, patient memory for treatment is limited. The Memory Support Intervention was developed to improve patient memory for treatment and thereby strengthen treatment outcomes. In this secondary analysis, the primary, preregistered aim was to test the 12-month follow-up outcomes of the Memory Support Intervention when used with cognitive therapy (CT + MS) for major depressive disorder, relative to CT-as-usual. The secondary, exploratory aim was to investigate opportunities to improve efficacy of the Memory Support Intervention.

METHOD

Adults (N = 178) with major depressive disorder were randomized to CT-as-usual or CT + MS. Therapist use of memory support and patient memory for treatment, depression symptoms, and overall functioning were measured in blind assessments.

RESULTS

Findings did not support differences between treatment conditions at 12-month follow-up. Therapists used memory support strategies with a narrow subset of treatment contents, and similarly, patients recalled a narrow subset of treatment contents.

CONCLUSIONS

The findings highlight ways to strengthen the efficacy of the Memory Support Intervention, such as applying memory support strategies across a wider variety of treatment contents, which in turn, may boost patient recall and outcomes.

摘要

目的

患者对治疗的记忆正在成为治疗结果的一个重要的跨诊断机制。然而,患者对治疗的记忆是有限的。记忆支持干预措施的开发是为了改善患者对治疗的记忆,从而加强治疗结果。在这项二次分析中,主要的、预先注册的目的是测试记忆支持干预措施与认知疗法(CT+MS)联合用于治疗重度抑郁症的 12 个月随访结果,与 CT 常规治疗相比。次要的、探索性的目的是调查改善记忆支持干预措施疗效的机会。

方法

将 178 名重度抑郁症患者随机分配到 CT 常规治疗或 CT+MS 治疗组。盲法评估治疗师使用记忆支持和患者对治疗的记忆、抑郁症状和整体功能。

结果

研究结果不支持治疗 12 个月后治疗条件的差异。治疗师使用记忆支持策略的治疗内容范围较窄,患者回忆的治疗内容也相似。

结论

这些发现强调了如何加强记忆支持干预措施的疗效,例如将记忆支持策略应用于更广泛的治疗内容,这反过来又可能提高患者的记忆和治疗效果。

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