Background: Several studies of moderate-to-severe depression have shown that combined treatment with individual cognitive behavioral therapy (CBT) and antidepressant medication is better than either CBT or antidepressants alone. Less research has focused on the outcomes of group-CBT and antidepressants in persons with mild depression.
Aim: Evaluate the effects of group-CBT in combination with antidepressants on the quality of life and social functioning of outpatients with mild depression.
Methods: We randomized 62 outpatients with mild depression into a control group (n=30) that received antidepressant medication for 12 weeks and an intervention group (n=32) that received antidepressants and group-CBT for 12 weeks; both groups were then continued on antidepressants alone for one year. Blinded evaluators used Chinese versions of the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Social Disability Screening Schedule, Life Satisfaction Rating, Multidimensional Scale of Perceived Social Support, and Short Form Health Survey to assess participants after 12 weeks of treatment and at the end of one year of follow-up.
Results: Repeated measures analysis of variance showed that the depressive and anxiety symptoms of both groups improved significantly during treatment and that the improvement was greater in the CBT+antidepressant experimental group. Almost all of the social functioning, social support, and quality of life measures also showed significantly greater improvement in the CBT+antidepressant group than in the antidepressant-only group. Moreover, even after adjusting for differences in baseline demographic and clinical characteristics and for changes in the severity of depression and anxiety over time using an analysis of covariance, the greater improvement in the CBT+antidepressant group remained statistically significant both after the 12 weeks of group-CBT treatment and one year after the group CBT had ended.
Conclusion: Antidepressants alone or combined treatment with antidepressants and group-CBT can effectively improve the social function, quality of life, and healthy functioning of individuals with mild depression. However, combined treatment with both antidepressants and group CBT is better than treatment with antidepressants alone, and these benefits persist for up to one year after the CBT sessions have ended.
背景: 有关中度至重度抑郁症的一些研究表明，联合使用认知行为治疗 (cognitive behavioral therapy, CBT) 与抗抑郁药物的效果优于单独使用 CBT 或抗抑郁药物。很少研究关注团体 CBT 治疗和药物治疗对轻度抑郁症患者的效果。.
目的: 评估联合使用团体CBT 治疗与抗抑郁药物对轻度抑郁患者生活质量及社会功能的影响。.
方法: 我们将62 例轻度抑郁症患者随机分为对照组(n=30) 与干预组 (n=32)，对照组予以抗抑郁药物治疗12 周，干预组予以抗抑郁药物合并团体 CBT 治疗12周；此后，两组均持续药物治疗1年。在治疗后12 周和一年随访结束时，对所有被试采用盲法进行汉密顿抑郁量表中文版 (Chinese versions of the Hamilton DepressionRating Scale)、汉密顿焦虑量表 (Hamilton Anxiety RatingScale)、社会功能缺陷筛选量表 (Social Disability ScreeningSchedule)、生活满意度评定量表 (Life SatisfactionRating)、多维社会支持感知 (Multidimensional Scale ofPerceived Social Support) 和简明健康调查量表 (ShortForm Health Survey) 的评估。.
结果: 重复测量的方差分析显示，治疗期间两组的抑郁和焦虑症状均明显改善，联合 CBT 与抗抑郁药物治疗的干预组的改善更大。几乎所有的社会功能、社会支持和生活质量评估同时表明CBT 合并抗抑郁药物组比单用抗抑郁药物组的改善显著更多。此外，即使采用的协方差分析调整了基线时的人口学差异和临床特征以及随时间推移的抑郁和焦虑严重程度的变化差异，CBT 合并抗抑郁药物组在团体治疗后12 周和团体治疗结束后的一年后都比单用抗抑郁药物组的改善更为明显，且有统计学差异。.
结论: 单用抗抑郁药物或联合抗抑郁药治疗和团体 CBT 治疗都可以有效地改善轻度抑郁症患者的社会功能、生活质量和健康功能。然而，合并药物治疗和团体 CBT 治疗优于单用抗抑郁药物治疗，而且这些效益可以在 CBT 疗程结束后持续至少长达1年。.
中文全文: 本文全文中文版从2016年5月25日起在http://dx.doi.org/10.11919/j.issn.1002-0829.215116可供免费阅览下载.
Keywords: China; antidepressants; cognitive-behavioral therapy; depression; group therapy; quality of life; social function.