基于正念的在线认知行为疗法治疗难治性抑郁症：一项平行组随机对照可行性试验。

Online mindfulness-based cognitive therapy for treatment-resistant depression: a parallel-arm randomized controlled feasibility trial.

作者信息

Rodrigues Michele Ferreira, Quagliato Laiana, Appolinario Jose Carlos, Nardi Antonio E

机构信息

Institute of Psychiatry (IPUB) of Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.

出版信息

Front Psychol. 2024 Jul 2;15:1412483. doi: 10.3389/fpsyg.2024.1412483. eCollection 2024.

DOI:10.3389/fpsyg.2024.1412483

PMID:39021648

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11252472/

Abstract

INTRODUCTION

Treatment-resistant depression (TRD) presents a significant challenge, affecting approximately 30% of individuals diagnosed with major depressive disorder and leading to poor treatment responses. Innovations in digital mental health, especially online mindfulness-based cognitive therapy (eMBCT), offer promising avenues for enhancing access to effective mental health care for individuals with TRD in a clinical setting.

OBJECTIVE

The aim of this study was to examine the feasibility of eMBCT in an individual clinical context to decrease depressive symptoms for TRD.

METHODS

Conducted at the Institute of Psychiatry of the Federal University of Rio de Janeiro, Brazil, this parallel-arm, randomized controlled feasibility trial involved outpatients diagnosed with TRD, aged 18 and above. Of the 39 outpatients invited, 28 were randomized into two groups: an intervention group receiving the eMBCT program ( = 15) and a control group ( = 13). The intervention, consisting of an 8-week course, was delivered via live video sessions. Following the assessment period, participants in the control group were offered the eMBCT intervention. Assessments using standardized questionnaires were conducted at the start and end of the study.

RESULTS

Within the eMBCT group, improvements were observed in depression symptoms ( = -3.423; = 0.001; effect size = 0.78), anxiety symptoms ( = -3.361; = 0.001; effect size = 0.77), with no significant changes in the control group. Comparatively, the eMBCT group showed significant reductions in depression symptoms and improvements in clinical global impressions over the control group (BDI2: = 30.5; = 0.015; effect size = 0.47, CGI1: = 21.0; = 0.004; effect size = 0.56).

CONCLUSION

eMBCT in an individual format combined with medication, appears to be a feasible treatment for TRD, decreasing symptoms of depression. In a future trial the control group may have a manualized intervention.

CLINICAL TRIAL REGISTRATION

The Brazilian Clinical Trials Registry: (https://ensaiosclinicos.gov.br/rg/RBR-6zndpbv) and RBR-6zndpbv.

摘要

引言

难治性抑郁症（TRD）是一个重大挑战，约30%被诊断为重度抑郁症的患者受其影响，导致治疗反应不佳。数字心理健康领域的创新，尤其是基于正念的在线认知疗法（eMBCT），为在临床环境中增强TRD患者获得有效心理健康护理的机会提供了有前景的途径。

目的

本研究旨在探讨eMBCT在个体临床环境中减轻TRD患者抑郁症状的可行性。

方法

该平行组随机对照可行性试验在巴西里约热内卢联邦大学精神病学研究所进行，纳入18岁及以上被诊断为TRD的门诊患者。在邀请的39名门诊患者中，28名被随机分为两组：干预组（n = 15）接受eMBCT项目，对照组（n = 13）。干预为期8周，通过实时视频课程进行。评估期结束后，对照组患者接受eMBCT干预。在研究开始和结束时使用标准化问卷进行评估。

结果

在eMBCT组中，抑郁症状（t = -3.423；p = 0.001；效应量 = 0.78）和焦虑症状（t = -3.361；p = 0.001；效应量 = 0.77）均有改善，而对照组无显著变化。相比之下，eMBCT组在抑郁症状减轻和临床总体印象改善方面显著优于对照组（BDI2：t = 30.5；p = 0.015；效应量 = 0.47，CGI1：t = 21.0；p = 0.004；效应量 = 0.56）。