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抑郁症的药物治疗与心理治疗——互补还是排斥?

Pharmacotherapy and psychotherapy in depression - complementarity or exclusion?

作者信息

Mosiołek Anna, Podlecka Marlena

机构信息

Department of Forensic Psychiatry, Institute of Psychiatry and Neurology in Warsaw, Poland.

Department of Neuroses, Personality Disorders and Eating Disorders, Institute of Psychiatry and Neurology in Warsaw, Poland.

出版信息

Postep Psychiatr Neurol. 2024 Dec;33(4):257-266. doi: 10.5114/ppn.2024.147104. Epub 2025 Feb 25.

Abstract

PURPOSE

This article attempts to outline the dilemma regarding the use of pharmacotherapy and psychotherapy in the treatment of mental disorders with particular emphasis on depression. Depressive disorder is one of the most common mental disorders suffered by society; it affects from 5% to over 12% of the population [1]. It is also a growing problem as the number of diagnoses has increased over the last decades.

VIEWS

The numerous organisations working to improve mental health have constructed guidelines focused on shaping preventive intervention and therapeutic procedures. However, the method of selecting a procedure remains unclear, with the choice between pharmacotherapy and psychotherapy being particularly troublesome. This begs the question of whether these forms of interaction are complementary or exclusive. The article provides an overview of the current discussion on the legitimacy of using multiple forms of interactions when treating depression. Currently, the treatment of depression is based primarily on pharmacotherapy using antidepressants and psychotherapy as well as combined treatment.

CONCLUSIONS

Although a diverse range of psychotherapeutic approaches are used to treat depression, research indicates that all leading approaches are similarly effective. Pharmacotherapy and psychotherapy offer comparable effectiveness in reducing depressive symptoms and demonstrate similar effects on neuronal activity. Combined treatment may offer optimal effectiveness, especially with moderate and severe symptoms of depression.

摘要

目的

本文试图概述在精神障碍治疗中使用药物治疗和心理治疗所面临的困境,尤其着重于抑郁症。抑郁症是社会中最常见的精神障碍之一;它影响着5%至超过12%的人口[1]。随着过去几十年诊断数量的增加,这也是一个日益严重的问题。

观点

众多致力于改善心理健康的组织已经制定了侧重于塑造预防干预和治疗程序的指南。然而,选择程序的方法仍不明确,药物治疗和心理治疗之间的选择尤其棘手。这就引出了一个问题,即这些互动形式是互补的还是相互排斥的。本文概述了当前关于在治疗抑郁症时使用多种互动形式的合理性的讨论。目前,抑郁症的治疗主要基于使用抗抑郁药的药物治疗、心理治疗以及联合治疗。

结论

尽管多种心理治疗方法被用于治疗抑郁症,但研究表明,所有主要方法的效果都相似。药物治疗和心理治疗在减轻抑郁症状方面具有相当的效果,并且对神经元活动表现出相似的影响。联合治疗可能提供最佳效果,尤其是对于中度和重度抑郁症症状。

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