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1.
Efficacy of interpersonal psychotherapy for depressed adolescents. 总被引:14,自引:0,他引:14
BACKGROUND: Psychotherapy is widely used for depressed adolescents, but evidence supporting its efficacy is sparse. METHODS: In a controlled, 12-week, clinical trial of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), 48 clinic-referred adolescents (aged 12-18 years) who met the criteria for DSM-III-R major depressive disorder were randomly assigned to either weekly IPT-A or clinical monitoring. Patients were seen biweekly by a "blind" independent evaluator to assess their symptoms, social functioning, and social problem-solving skills. Thirty-two of the 48 patients completed the protocol (21 IPT-A-assigned patients and 11 patients in the control group). RESULTS: Patients who received IPT-A reported a notably greater decrease in depressive symptoms and greater improvement in overall social functioning, functioning with friends, and specific problem-solving skills. In the intent-to-treat sample, 18 (75%) of 24 patients who received IPT-A compared with 11 patients (46%) in the control condition met recovery criterion (Hamilton Rating Scale for Depression score < or =6) at week 12. CONCLUSIONS: These preliminary findings support the feasibility, acceptability, and efficacy of 12 weeks of IPT-A in acutely depressed adolescents in reducing depressive symptoms and improving social functioning and interpersonal problem-solving skills. Because it is a small sample consisting largely of Latino, low socioeconomic status adolescents, further studies must be conducted with other adolescent populations to confirm the generalizability of the findings. 相似文献
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目的探讨认知治疗与团体人际心理治疗对产后抑郁症患者的疗效及差异。方法完成全程治疗及随访的产后押郁症患者共110例,37例予认知治疗,38例予团体人际心理治疗,35例接受一般随访。治疗前、治疗后3个月及6个月末分别对3组进行爱丁堡产后抑郁量表(EPDS)、汉密尔顿抑郁量表(HAMD)、功能失调性态度问卷(DAS)及人际问题问卷(IIP)测试。结果认知治疗组和人际心理治疗组随访3个月和6个月后的EPDS总分及HAMD总分均明显低于对照组(P〈0.05),认知治疗及人际心理治疗组治疗后3个月及6个月的EPDS、HAMD总分低于治疗前(P〈0.05)。认知治疗组治疗后6个月的EPDS总分、HAMD总分及DAS总分均明显低于人际心理治疗组(P〈0.05)。结论认知治疗和团体人际心理治疗对产后抑郁症均有疗效,但认知治疗疗效更为显著。 相似文献
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Efficacy of interpersonal psychotherapy as a maintenance treatment of recurrent depression. Contributing factors. 总被引:2,自引:0,他引:2
E Frank D J Kupfer E F Wagner A B McEachran C Cornes 《Archives of general psychiatry》1991,48(12):1053-1059
In earlier reports, we demonstrated that in patients with recurrent unipolar depression, survival time without a new episode of major depression following discontinuation of medication was significantly and positively related to continued interpersonal psychotherapy (IPT). To determine whether the prophylactic benefit of monthly sessions of IPT was a function of specific features of the intervention, we examined the contribution of the quality of IPT sessions to the length of the well interval in this 3-year maintenance trial. Therapy sessions were rated on specificity and purity of interpersonal interventions. Analysis of these ratings indicated that psychotherapy that was more specifically interpersonal was associated with significantly increased survival time. Patients whose therapy sessions were rated above the median on specificity of IPT had a median survival time of almost 2 years, while those below the median had a median survival time of less than 5 months. We concluded that when patient and therapist are able to maintain a high level of interpersonal focus, monthly sessions of IPT have substantial prophylactic benefit. 相似文献
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Swartz HA Frank E Shear MK Thase ME Fleming MA Scott J 《Psychiatric services (Washington, D.C.)》2004,55(4):448-450
A matched-case-control study compared eight-week outcomes between a group of 16 depressed women who received brief (eight-session) interpersonal psychotherapy and a group of 16 who received a selective serotonin reuptake inhibitor (sertraline). Women who met DSM-IV criteria for major depression and who had a score above 15 on the Hamilton Rating Scale for Depression were treated openly with brief interpersonal psychotherapy and were matched on key variables with women being treated with sertraline. Linear mixed-effects regression models were used to compare groups on measures of symptoms and functioning during eight weeks of treatment. Both groups improved significantly over time, with large effect sizes. However, contrary to expectations, the women who received psychotherapy improved more quickly than those who received sertraline. 相似文献
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J.C. Levenson E. Frank Y. Cheng P. Rucci C.A. Janney P. Houck R.N. Forgione H.A. Swartz J.M. Cyranowski A. Fagiolini 《Depression and anxiety》2010,27(5):434-440
Background: Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose psychotherapy focused on each problem area. Moreover, we sought to understand how the patient characteristics and interpersonal problems most closely linked to the onset of a patient's current depression contributed to IPT success. Methods: Patients meeting DSM‐IV criteria for an episode of major depressive disorder ( n =182) were treated with weekly IPT. Remission was defined as an average Hamilton Rating Scale for Depression 17‐item score of 7 or below over 3 weeks. Personality disorders were diagnosed using the Structured Clinical Interview for DSM‐IV Personality Disorders. Results: Contrary to our prediction that patients whose treatment was focused on interpersonal deficits would take longer to remit, survival analyses indicated that patients receiving treatment focused on each of the four problem areas did not differ in their times to remission. Nor were patients in the interpersonal deficits group more likely to have an Axis II diagnosis. Patients whose treatment focused on role transitions remitted faster than those whose treatment focused on role disputes, after controlling for covariates. Conclusion: With skillful use of IPT strategies and tactics and with careful medication management where appropriate, patients in this study whose treatment focused on each problem area were treated with equal success by trained IPT clinicians. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc. 相似文献
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Magalhães PV Pinheiro RT Faria AD Osório CM da Silva RA Botella L 《The Journal of nervous and mental disease》2007,195(10):870-873
In this study, we evaluated the impact of defense style (DS) on outcome and its relation to the therapeutic alliance. Women with postpartum depression were allocated to a brief psychotherapeutic intervention. To evaluate DS and the therapeutic alliance, the Defense Style Questionnaire and the Working Alliance Inventory were employed. The main outcome was the Edinburgh Postnatal Depression Scale score at end point; anxiety and retention in treatment were also evaluated. Fifty-nine patients were included; 46 completed the therapy and 65.4% responded (Edinburgh Postnatal Depression Scale score <10). Intense use of immature defenses was related to persistence of depression and anxiety symptoms at end point, even when controlled for potential confounders. Results tended to confirm a hierarchy of DSs independently of the alliance. Clinicians should be aware of possible differential responses to brief psychotherapies related to DS. 相似文献
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Schulberg HC Post EP Raue PJ Have TT Miller M Bruce ML 《International journal of geriatric psychiatry》2007,22(2):106-114
BACKGROUND: Interpersonal psychotherapy (IPT) is an empirically-validated intervention for treating late-life depression. OBJECTIVE: To determine the manner in which IPT is utilized by primary care physicians in relation to antidepressant medications. METHODS: The authors reviewed treatment logs prepared by care managers during the first 12 months of a patient's participation in the PROSPECT clinical trial to determine initial and longitudinal treatment patterns utilized by physicians, and clinical outcomes associated with initial treatment assignment. RESULTS: Primary care physicians in practices randomized to PROSPECT's intervention arm initially prescribed an antidepressant medication for 58% of eligible patients and referred only 11% of them to IPT. Over time, however, 27% of patients participated in IPT as monotherapy or augmentation therapy. Initial treatment assignment was not associated with depressive status at 4 and 12 months nor with suicidal ideation at 4, 8, and 12 months. CONCLUSION: IPT is an effective treatment for late-life depression whose greater use by primary care physicians should be encouraged. 相似文献
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This paper describes a method for measuring the interventions employed by psychotherapists in the short-term interpersonal treatment of depressive disorders. The psychotherapy techniques are described, and the methodology for measuring these techniques is presented. These are illustrated with the findings of the collaborative Boston-New Haven project. 相似文献
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Horn H Geiser-Elze A Reck C Hartmann M Stefini A Victor D Winkelmann K Kronmüller KT 《Praxis der Kinderpsychologie und Kinderpsychiatrie》2005,54(7):578-597
Depression is highly prevalent in children and adolescents. Psychodynamic therapies are only insufficiently evaluated in this field although many children and adolescents suffering from depression are treated using this approach. Therefore, the aim of our study was to evaluate the efficacy of psychodynamic short-term psychotherapy (PSTP) for the treatment of depression in children and adolescents. In a waiting-list controlled study, 20 children and adolescents fulfilling diagnosis of major depression or dysthymia were included. The treatment group received 25 sessions of psychodynamic psychotherapy. Main outcome criterion was the Impairment-Score for Children and Adolescents (IS-CA) as well as the Psychic and Social-Communicative Findings Sheet for Children and Adolescents (PSCFS-CA) and the Child Behavior Checklist (CBCL), which were assessed at the beginning and the end of treatment. The statistical and clinical significance of changes in these measures were evaluated. There was a significant advantage of the treatment group compared to the waiting group for the IS-CA. The effect size of the IS-CA total score was 1,3. In contrast to the treatment group, where 20% of the children showed clinically significant and reliable improvement, no subject in the waiting-list control group met this criterion. Comparable results were found for the PSCFS-CA and for the internalising score assessed with the CBCL. The results show that psychodynamic short-term psychotherapy (PSTP) is an effective treatment for depressed children and adolescents. Still, some of the children surely require more intensive treatment. 相似文献
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J Yager 《The American journal of psychiatry》2012,169(8):872-873
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盐酸氟西汀联合认知行为疗法治疗产后抑郁症疗效观察 总被引:3,自引:0,他引:3
贾玉芳 《实用神经疾病杂志》2013,(23):53-54
目的 探讨盐酸氟西汀联合认知行为疗法治疗产后抑郁症的临床疗效及不良反应.方法 入组103例产后抑郁症患者分为2组,联合治疗组53例接受盐酸氟西汀联合认知行为疗法,对照组50例仅接受盐酸氟西汀治疗.2组均治疗6周.然后采用汉密尔顿抑郁量表(HAMD)评价治疗效果,同时采用不良反应量表(TESS)评价盐酸氟西汀的不良反应.结果 联合治疗组总有效率84.9%,远高于对照组68.0%(P〈0.05).联合治疗组治疗后HAMD评分低于对照组(P〈0.05).2组药物不良反应比较差异无统计学意义(P〉0.05).结论 盐酸氟西汀联合认知行为疗法治疗产后抑郁症的临床疗效优于单用盐酸氟西汀,而不良反应并未增加. 相似文献
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Mohr DC Hart SL Julian L Catledge C Honos-Webb L Vella L Tasch ET 《Archives of general psychiatry》2005,62(9):1007-1014
BACKGROUND: Several studies have shown that telephone-administered cognitive-behavioral therapy (T-CBT) is superior to forms of no treatment controls. No study has examined if the skills-training component to T-CBT provides any benefit beyond that provided by nonspecific factors. OBJECTIVE: To test the efficacy of a 16-week T-CBT against a strong control for attention and nonspecific therapy effects. DESIGN: Randomized controlled trial including 12-month follow-up. SETTING: Telephone administration of psychotherapy with patients in their homes. PARTICIPANTS: Participants had depression and functional impairments due to multiple sclerosis. INTERVENTIONS: A 16-week T-CBT program was compared with 16 weeks of telephone-administered supportive emotion-focused therapy. MAIN OUTCOME MEASURES: Hamilton Depression Rating Scale score, Structured Clinical Interview for DSM-IV diagnosis of major depressive disorder, Beck Depression Inventory score, and Positive Affect scale score of the Positive and Negative Affect Scale. RESULTS: Of the 127 participants randomized, 7 (5.5%) dropped out of treatment. There were significant improvement during treatment on all outcome measures (P<.01 for all) and an increase in Positive Affect Scale score. Improvements over 16 weeks of treatment were significantly greater for T-CBT, compared with telephone-administered supportive emotion-focused therapy, for major depressive disorder frequency (P = .02), Hamilton Depression Rating Scale score (P = .02), and Positive Affect Scale score (P = .008), but not for the Beck Depression Inventory score (P = .29). Treatment gains were maintained during 12-month follow-up; however, differences across treatments were no longer evident (P > .16 for all). CONCLUSIONS: Patients showed significant improvements in depression and positive affect during the 16 weeks of telephone-administered treatment. The specific cognitive-behavioral components of T-CBT produced improvements above and beyond the nonspecific effects of telephone-administered supportive emotion-focused therapy on evaluator-rated measures of depression and self-reported positive affect. Attrition was low. 相似文献
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Developments in interpersonal psychotherapy. 总被引:1,自引:0,他引:1
J C Markowitz 《Revue canadienne de psychiatrie》1999,44(6):556-561
BACKGROUND: Interpersonal psychotherapy (IPT), a time-limited psychotherapy, was developed in the 1970s as a treatment for outpatient adults with major depression. It since has grown in its range of research applications and in its clinical accessibility. METHOD: Review of recent research and educational developments on IPT. RESULTS: IPT has demonstrated efficacy in randomized controlled trials for major depression in various patient populations and in patients with bulimia. It showed no advantages in treating 2 substance abuse samples. Numerous further studies are underway. Growing numbers of clinicians are learning IPT. CONCLUSIONS: At a time when both research developments and economic pressures are increasing interest in time-limited psychotherapies, IPT is expanding in both the research and clinical domains. 相似文献
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Ulrike Feske Ellen Frank David J. Kupfer M. Katherine Shear Elizabeth Weaver 《Depression and anxiety》1998,8(4):135-141
Major depression and anxiety frequently co-occur, but the implications for psychological treatments have rarely been studied. We examined predictors of acute response to interpersonal psychotherapy in 134 consecutively treated female outpatients with recurrent unipolar depression. Women who failed to remit with interpersonal psychotherapy alone experienced higher levels of somatic anxiety, were more likely to meet criteria for lifetime panic disorder, were more likely to meet criteria for nonendogenous or nonmelancholic depression, and reported greater vocational impairment, higher levels of global severity, a longer duration of the index episode, and, somewhat surprisingly, lower levels of social impairment at pretreatment evaluation. A series of backwards stepping logistic regression analyses showed higher levels of baseline somatic anxiety and social functioning to be the most consistent predictors of nonresponse. Our findings strengthen existing evidence that concomitant anxiety can adversely affect the outcome of interpersonal therapy for depression. Depression and Anxiety 8:135–141, 1998. © 1998 Wiley-Liss, Inc. 相似文献