Telephone Versus Face-to-Face Administration of CBT for Depression

电话与面对面治疗抑郁症的 CBT 管理

基本信息

批准号：
7663752
负责人：
DAVID CURTIS MOHR
金额：
$ 103.23万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2000
资助国家：
美国
起止时间：
2000-09-08 至 2012-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7663752
关键词：
Accounting Advisory Committees American Psychological Association Antidepressive Agents Appointments and Schedules Behavioral Caring Client satisfaction Clinical Cognitive Counseling Data Development Disabled Persons Drops Education Emotional Emotions Enrollment Face Failure Freedom Grant Health Health Personnel Health Policy Health Services Health Services Accessibility Healthcare Home environment Individual Intervention Life Literature Low income Major Depressive Disorder Measures Mediating Mediator of activation protein Mental Health Meta-Analysis Modeling Motivation Multiple Sclerosis National Institute of Mental Health Outcome Outcome Measure Patients Pharmaceutical Preparations Pharmacotherapy Phase Population Prevalence Primary Health Care Provider Psychotherapy Relative (related person)Reporting Research Research Personnel Sampling Services Site Societies Specialist Specific qualifier value Stigmata Telephone Testing Therapeutic Time Transportation Treatment outcome United States Upper arm Veterans Western World Work caregiving cognitive behavior therapy comparative efficacy cost demographics depressed depression design disability effective therapy experience follow-up functional disability health administration preference programs psychosocial residence rural area satisfaction social stigma

项目摘要

DESCRIPTION (provided by applicant): Major depressive disorder (MOD) is common, with 12-month prevalence rates estimated at between 6.6- 10.3%. A large literature has established that depression can be effectively treated using pharmacotherapy and/or psychotherapy. Several studies have found that given a choice, about two-thirds of depressed patients prefer psychotherapy or counseling over antidepressant medication. While psychotherapy is both effective and ostensibly desirable, a variety of barriers exist both to initiating and maintaining psychotherapy. Only about 20% of all patients referred for psychotherapy ever follow-up. Of those who do initiate psychotherapy, nearly half drop out prior to completion of treatment. Administering psychotherapy over the telephone may overcome many barriers associated with failure to initiate treatment and attrition from treatment. A number of recent studies have shown that telephone- administered treatments are effective at reducing depression, well accepted by patients, able to extend treatment to patients who experience significant barriers including disabilities. Furthermore, telephone administered psychotherapies are likely associated with low rates of attrition, compared to treatments delivered face-to-face. This study will compare a 16-week telephone-administered cognitive behavioral therapy (T-CBT) intervention to 16 weeks of face-to-face CBT (FtF-CBT). It is hypothesized that 1)T-CBT will produce lower rates of attrition compared to FtF-CBT, 2) intent-to-treat analyses will show T-CBT to produce significantly greater reductions in depression compared to FtF-CBT, in the sample initiating treatment and 3) the greater reductions in depression associated with T-CBT will be fully mediated by attrition. This research has the potential to produce a manualized T-CBT program that could extend treatment to many populations who are currently unable to access care.

描述（由申请人提供）：重度抑郁症（MOD）很常见，估计为6.6- 10.3％的12个月患病率。大量文献证明，可以使用药物治疗和/或心理治疗有效治疗抑郁症。几项研究发现，有一个选择，大约三分之二的抑郁症患者喜欢心理治疗或咨询而不是抗抑郁药。虽然心理治疗既有效又表面上是可取的，但既有障碍，既可以发起和维持心理疗法。在所有参考心理治疗的患者中，只有大约20％的患者进行了随访。在那些启动心理治疗的人中，将近一半在完成治疗之前辍学。通过电话进行心理治疗可能会克服与未能从治疗中启动治疗和损耗相关的许多障碍。最近的许多研究表明，电话管理的治疗可有效减少抑郁症，该抑郁症被患者广泛接受，能够扩展到患有重大障碍（包括残疾）的患者的治疗。此外，与面对面交付的治疗相比，电话管理的心理治疗可能与降压率低有关。这项研究将比较16周的电话管理认知行为疗法（T-CBT）干预与面对面CBT的16周（FTF-CBT）。假设1）与FTF-CBT相比，T-CBT将产生较低的损耗率，2）与FTF-CBT相比，与FTF-CBT相比，意图对治疗分析将显示T-CBT显着降低抑郁症，而在样本启动治疗中和3）与T-CBT相关的抑郁症的降低更大。这项研究有可能制定手动T-CBT计划，该计划可能会将治疗扩展到许多目前无法获得护理的人群。