スキーマ療法は重度のうつ病に有効である(Schema therapy is effective for treating severe depression)

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2024-02-19 マックス・プランク研究所

スキーマ療法は、心理療法としてますます使用されています。ここでは、早期の幼少期の経験や感情に焦点を当て、現在の症状や精神障害に貢献しています。これまで、うつ病に対するスキーマ療法の効果は、外来設定でのみ調査されてきました。しかし、ドイツ・ミュンヘンのマックス・プランク精神医学研究所の研究者たちは、OPTIMA研究の枠組みで、スキーマ療法の効果を入院患者での重度のうつ病治療において試験しました。その結果、スキーマ療法は認知行動療法と同等に効果的であり、現在最も効果的な心理療法治療となりました。

<関連情報>

入院患者およびデイ・クリニックにおけるうつ病に対するスキーマ療法対認知行動療法対支持療法の有効性: 無作為臨床試験 Effectiveness of Schema Therapy versus Cognitive Behavioral Therapy versus Supportive Therapy for Depression in Inpatient and Day Clinic Settings: A Randomized Clinical Trial

Johannes Kopf-Beck;Celina L. Müller;Jeanette Tamm;Julia Fietz;Nils Rek;Leah Just;Zoe Ilona Spock;Katharina Weweck;Keisuke Takano;Martin Rein;Martin E. Keck;Samy Egli
Psychotherapy and Psychosomatics  Published:January 04 2024
DOI:https://doi.org/10.1159/000535492

スキーマ療法は重度のうつ病に有効である(Schema therapy is effective for treating severe depression)

Abstract

Introduction: Schema therapy (ST) reduces depressive symptoms, but clinical trials have not investigated its effectiveness for patients suffering from severe forms of depression and high rates of comorbidities. There is high demand for exploring and improving treatments for this patient group. The objective of the current study was to evaluate whether ST is more effective than individual supportive therapy (IST) and noninferior compared with cognitive behavioral therapy (CBT) in treating depression. Methods: For this clinical trial, medicated patients were recruited in inpatient and day clinic settings. The major inclusion criteria were age between 18 and 75 years and primary diagnosis of depression without psychotic symptoms. A total of 292 participants were randomized to ST, CBT, or IST and received 7 weeks of psychotherapy (up to 14 individual and 14 group sessions). The primary outcome was change in depression severity after treatment measured by Beck Depression Inventory-II. Primary test for efficacy was superiority of ST over IST. Secondary test was noninferiority of ST compared with CBT. Multilevel modeling was conducted. The results at 6-month follow-up were explored. Results: Across treatment, ST was not superior to IST. Secondary outcome analyses and completer analyses showed similar results. However, ST showed clinically relevant noninferiority compared with CBT. Conclusion: ST for depression as part of a psychiatric care program showed clinical noninferiority compared to CBT, without being superior to IST. ST represents a potentially useful addition to the therapeutic repertoire for the treatment of depression but its efficacy, including long-term efficacy, should be evaluated further.

医療・健康
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