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俄罗斯的人际心理治疗:铭记心灵的旧日创伤,保持对忧郁文化的觉察,重新与支持性的社会环境建立联系。

Interpersonal Psychotherapy in Russia: Remembering Past Losses of the Heart, Keeping Mindful of the Culture of Melancholy, and Reconnecting with a Supportive Social Environment.

机构信息

Reaviz Medical University, 443016 Samara, Russia,

出版信息

Psychiatr Danub. 2024 Sep;36(Suppl 2):332-337.

PMID:39378492
Abstract

BACKGROUND

The dissolution of the Soviet Union brought economic instability and variety of social changes, resulting in fluctuating suicide rates and highlighting the national phenomenon of a melancholy cultural trait across the general population. The socio-political changes in Russia post-1991 led to increased rates of depressive and stress-related disorders, as well as opening avenues for integrating foreign psychotherapeutic methods, including Interpersonal Psychotherapy (Klerman-Weissman IPT), into the treatment of mental disorders. This narrative review explores the adaptation and efficacy of IPT in Russia, particularly for depressive and stress-related disorders.

MATERIAL AND METHODS

We assembled key PhD theses related to the topic of IPT use in Russia. One such study involved 120 female patients aged 23-45 years with adjustment disorders, treated at the Omsk Rehabilitation Treatment Hospital. Participants were divided into an IPT group (n=80) and a control group (n=40) receiving treatment as usual (TAU). The IPT group underwent 12-16 individual sessions, each lasting 60 minutes, held twice a week. The main study group was further divided into four sub-groups based on specific interpersonal problems: loss of loved ones, interpersonal conflicts, social role changes, and social isolation.

RESULTS

Both groups showed improvement in anxiety, dyssomnia, and motor retardation, with the IPT group demonstrating more sustained improvement. At the 8-week endpoint, full recovery from depression was observed in 50% of the IPT group, compared to only 20% in the TAU group. The IPT group also showed significant improvements in coping strategies, with a notable decrease in avoidance behaviors and an increase in problem-solving strategies, also targeting melancholy national phenomenon via training acceptance skills and practicing an active life position to aware the self-responisbility and achieve a of well-being state of emotional balance. The group IPT method was also experimentally combined with the person-oriented (reconstructive) psychotherapy, which has a long and successful history of within the group format, and has enabled shortening of the standard course of person-oriented reconstructive treatment.

CONCLUSIONS

IPT method has proven efficacy in treating depressive and stress-related disorders in Russia, by addressing deeper pathogenetic levels of mental and behavioral formations. The Russian Society of Psychiatrists and Russian Psychotherapy Association have recommended its broader implementation in Russian mental health institutions, and has included IPT in the Russian National Guidelines for Psychiatry.

摘要

背景

苏联解体带来了经济不稳定和各种社会变革,导致自杀率波动,并凸显了整个俄罗斯民众忧郁文化特质的全国性现象。1991 年后俄罗斯的社会政治变革导致抑郁和应激相关障碍的发生率上升,同时也为整合包括人际心理治疗(Klerman-Weissman IPT)在内的外国民间心理治疗方法开辟了途径,用于治疗精神障碍。本叙述性综述探讨了 IPT 在俄罗斯的适应性和疗效,特别是在治疗抑郁和应激相关障碍方面。

材料与方法

我们收集了与 IPT 在俄罗斯使用相关的博士论文的关键内容。其中一项研究涉及 120 名年龄在 23-45 岁之间的患有适应障碍的女性患者,她们在鄂木斯克康复治疗医院接受治疗。参与者被分为 IPT 组(n=80)和对照组(n=40),对照组接受常规治疗(TAU)。IPT 组接受 12-16 次个体治疗,每次 60 分钟,每周两次。主要研究组进一步根据特定的人际问题分为四个亚组:失去亲人、人际冲突、社会角色变化和社会孤立。

结果

两组患者的焦虑、失眠和运动迟缓均有改善,IPT 组的改善更为持续。在 8 周的研究终点,IPT 组 50%的患者完全康复,而 TAU 组仅为 20%。IPT 组在应对策略方面也有显著改善,回避行为明显减少,解决问题的策略明显增加,通过训练接受技巧和练习积极的生活态度,也针对忧郁的民族现象,以提高自我责任感,实现情感平衡的幸福状态。IPT 组方法还通过实验与以人为导向(重建)心理治疗相结合,该方法在小组形式下具有悠久而成功的历史,并且能够缩短以人为导向的重建治疗的标准疗程。

结论

IPT 方法已被证明在俄罗斯治疗抑郁和应激相关障碍方面有效,通过解决精神和行为形成的更深层次的发病机制。俄罗斯精神病学协会和俄罗斯心理治疗协会建议在俄罗斯精神卫生机构更广泛地实施该方法,并将其纳入俄罗斯国家精神病学指南。

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