COGNITIVE AND ACTIVATION TREATMENTS FOR DEPRESSION

抑郁症的认知和激活治疗

• 批准号: 2034618
• 负责人: NEIL S JACOBSON
• 金额: $ 47.59万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-06-25 至 2002-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2034618
• 关键词: behavioral /social science research tag; clinical research; cognition; human subject; human therapy evaluation; major depression; mental disorder chemotherapy; placebos; psychological tests; psychotherapy; relapse /recurrence; sertraline; behavioral /social science research tag; clinical research; cognition; human subject; human therapy evaluation; major depression; mental disorder chemotherapy; placebos; psychological tests; psychotherapy; relapse /recurrence; sertraline

DESCRIPTION (Applicant's Abstract): Our primary aim of the proposed study is to document the efficacy of Behavioral Activation (BA) in the acute treatment of major depressive disorder (MDD), by comparing it to cognitive therapy (CT), Sertraline, and pill placebo (PLA). A second aim is to test the significance of the interaction between severity of MDD and response to pharmacological versus psychosocial treatments. A third aim is to determine whether or not BA and CT can prevent depressive relapse, by comparing these treatments during continuation and follow-up phases to a control group of subjects brought to remission with Sertraline and then switched to a placebo (SRD) after 16 weeks of acute treatment. A final aim is to examine the relapse prevention potential of BA and CT compared to a state-of-the-art, drug continuation regimen (SRC) for treatment responders. Our predictors are that both psychotherapies - CT and BA - as well as Sertraline will be more effective than PLA for the more severely depressed outpatients, but that the three active treatments will not be differentially effective at the end of acute treatment. At all follow-up points in time, we expect both psychotherapies - BA and CT - and SRC to be more effective at preventing relapse than SRD subjects. The implications for mental health policy are significant. Currently, pharmacotherapy constitutes the "gold standard" for maximizing the likelihood of acute treatment response. However, none of the pharmacotherapies are curative. If either BA, CT, or both prevent relapse, subjects with depression have treatment options, and medical costs may be significantly reduced. In particular, if BA, an extremely parismonious treatment, is not significantly less effective than CT after either 16 weeks of acute treatment response or at preventing relapse, we will have provided strong support that depressives can be maintained without medication at minimal costs. BA should be relatively easy to teach paraprofessional therapists, and perhaps can even be adapted to a self-administered format, because its intervention options are few, and the decision rules for implementation of particular interventions are straightforward.

描述（申请人的摘要）：拟议研究的主要目的 是记录行为激活（BA）在急性中的功效 通过将重度抑郁症（MDD）与认知进行比较 治疗（CT），舍曲林和药丸安慰剂（PLA）。 第二个目的是测试 MDD严重程度与对响应的相互作用的重要性 药理与社会心理治疗。 第三个目标是确定 通过比较，BA和CT是否可以防止抑郁复发 延续和随访阶段的治疗对照组 受试者用舍曲林缓解，然后切换到安慰剂 （SRD）经过16周的急性治疗。 最终目的是检查 与最先进的情况相比，BA和CT的复发潜力 治疗响应者的药物延续方案（SRC）。 我们的预测因素 是心理治疗 - CT和BA-以及舍曲林 对于更严重的门诊病人，比PLA更有效，但是 这三种主动治疗对在 急性治疗结束。 在所有后续的时间点，我们都希望 心理治疗 - BA和CT-以及SRC更有效地防止 复发比SRD受试者。 对心理健康政策的影响是 重要的。 目前，药物疗法构成 最大化急性治疗反应的可能性。 但是，没有 药物疗法是治愈性的。 如果BA，CT或两者都可以防止复发 患有抑郁症的受试者有治疗选择，医疗费用可能是 大幅减少。 特别是，如果ba，这是一个极其副主义的 16周后，治疗效果不如CT明显少得多 急性治疗反应或防止复发时，我们将提供 可以在没有药物治疗的情况下维持抑郁症的强烈支持 最低成本。 BA应该相对容易教授专业 治疗师，甚至可以适应自我管理的格式， 因为其干预选项很少，并且 特定干预措施的实施很简单。