后天性脑损伤后抑郁和焦虑症状患者的接纳与承诺疗法:BrainACT随机对照试验的结果

IF 3.5 2区 医学 Q2 PSYCHIATRY Journal of Psychosomatic Research Pub Date : 2024-09-12 DOI:10.1016/j.jpsychores.2024.111933
Johanne C.C. Rauwenhoff , Yvonne Bol , Frenk Peeters , Peter Smits , Annelien Duits , Melloney Wijenberg , Astrid Blok , Caroline M. van Heugten
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引用次数: 0

摘要

目的本研究旨在调查经调整的 ACT 干预(BrainACT)对后天性脑损伤后出现焦虑和/或抑郁症状的患者的有效性。方法本研究是一项多中心随机对照双臂平行试验。共有 72 名中风或脑外伤幸存者被随机分配到为期八节的 ACT 或对照组(即心理教育和放松)干预中。主要结果指标为医院焦虑抑郁量表(HADS)和抑郁焦虑压力量表(DASS)。次要结果为 ACT 过程测量、参与度和生活质量。在治疗前、治疗期间、治疗后以及 7 个月和 12 个月的随访中,由训练有素的评估人员进行结果评估,评估人员对治疗条件保密。除参与频率外,两组参与者在所有结果指标上都有明显改善。在抑郁症状和焦虑症状方面,临床相关的长期改善(即 HADS 的恢复或可靠变化)更倾向于 ACT。就个体而言,这项研究表明,与积极的对照干预相比,特别是在长期治疗方面,ACT 似乎更能在临床上减少焦虑和抑郁症状。然而,ACT 在改善 ACT 相关过程(如心理灵活性、认知化解和有价值的生活)以及提高参与度或生活质量方面并不占优势。该研究最初在荷兰试验注册中心(现为临床试验注册平台)注册,编号为NL-OMON50203。注册时间为2018年7月18日,现在可在https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON50203。
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Acceptance and commitment therapy for people with depressive and anxiety symptoms following acquired brain injury: Results of the BrainACT randomized controlled trial

Objective

This study aimed to investigate the effectiveness of an adapted ACT intervention (BrainACT) in people who experience anxiety and/or depressive symptoms following acquired brain injury.

Methods

The study is a multicentre randomized controlled two-arm parallel trial. In total, 72 people who survived a stroke or traumatic brain injury were randomized into an eight-session ACT or control (i.e. psycho-education and relaxation) intervention. The primary outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Depression Anxiety and Stress Scale (DASS). Secondary outcomes were ACT process measures, participation, and quality of life. Outcome assessments were performed by trained assessors, blinded to treatment condition, pre-treatment, during treatment, post-treatment, and at 7 and 12 months follow-up.

Results

There were no differences between groups on any outcome measure. Participants in both groups significantly improved on all outcome measures, except for participation frequency. More clinically relevant long-term improvements (i.e. recovered or reliable changes on the HADS) were found in favour of ACT for depressive and anxiety symptoms.

Conclusion

The study was negative on the primary outcome measures. On an individual level, this study showed that especially on the long term ACT seems to show a more clinically relevant decrease in anxiety and depressive symptoms compared to an active control intervention. However, ACT was not superior in improving ACT-related processes such as psychological flexibility, cognitive defusion, and valued living nor in increasing participation or quality of life. Further large-scale group studies are warranted.

Trial registration

The study was originally registered in the Dutch Trial Register (now Clinical Trial Registry Platform), NL-OMON50203. Registered on 18/07/2018 and now to be found under https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON50203.

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来源期刊
Journal of Psychosomatic Research
Journal of Psychosomatic Research 医学-精神病学
CiteScore
7.40
自引率
6.40%
发文量
314
审稿时长
6.2 weeks
期刊介绍: The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.
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