Rush A J
Am J Psychoanal. 1980 Summer;40(2):99-121. doi: 10.1007/BF01254804.
Too few research studies that identify effective therapeutic methods for treatment of psychotic depressions are available. A few studies indicate that cognitive therapy reduces symptoms and may provide prophylaxis in outpatients with moderately severe depressions. Cognitive theory provides a conceptual framework for developing techniques to treat more severely depressed patients. Specific obstacles in the psychotherapy of this group include negatively biased recall of current and past events; difficulties in forming a therapeutic alliance; memory and concentration deficits; hallucinations; delusions; and somatic complaints. This paper presents preliminary attempts to develop and apply cognitive change techniques to some of these difficulties. The role of medication in combination with psychotherapy, the identification of depressions requiring psychotheeapy, and the development of methods specific to psychotherapy with psychotic depressions and promising areas in need of further investigation.
目前几乎没有能确定治疗精神病性抑郁症有效治疗方法的研究。一些研究表明，认知疗法可减轻症状，并可能为中度严重抑郁症的门诊患者提供预防作用。认知理论为开发治疗更严重抑郁症患者的技术提供了概念框架。该群体心理治疗中的具体障碍包括对当前和过去事件的消极偏见性回忆；形成治疗联盟的困难；记忆和注意力缺陷；幻觉；妄想；以及躯体不适。本文展示了针对其中一些困难开发和应用认知改变技术的初步尝试。药物与心理治疗相结合的作用、需要心理治疗的抑郁症的识别，以及针对精神病性抑郁症心理治疗的特定方法的开发和有前景的需进一步研究的领域。
