抑郁症患者对基于正念的认知疗法(Mbct)反应的预测因素:机器学习的观点

M. Dethoor, Francois-Benois Vialatte, M. Martinelli, P. Péri, C. Lançon, M. Trousselard
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引用次数: 1

摘要

虽然有大量关于基于正念的干预措施(MBI)的益处的文献,但与其效率相关的因素的数据很少。我们的研究试图通过机器学习分析来确定基于正念的认知治疗(MBCT)的疗效和依从性的调节因素。“大学医院心理健康服务中心”的76名精神科门诊患者从他们的转诊精神科医生那里得到了MBCT的处方。他们患有各种精神疾病,并伴有抑郁症状。他们在8次MBCT干预前后完成了一系列临床、正念和心理功能自我报告问卷。得分的变化(减去之前)用于疗效。MBCT前的评分用于研究粘连情况(8次MBCT)与非粘连患者(8次前停止MBCT)。对于疗效和依从性概况,基于支持向量机(SMV)方法的机器学习分析被应用于补充经典统计分析。结果:对于疗效因素,SVM分析发现了患者的二维图谱。MBCT最有效的患者是具有高Beck评分(>25)和高特质正念(FFMQ>90)的患者。错误分类验证实例的百分比为24.6(LOO=75.4)。该模型的敏感性为79.3%,特异性为71.9%。对于依从性因素,建立了三维模型。进行8次MBCT的患者具有高或低特质正念、高或低身体分离和低自我同情的特征。错误分类的验证示例的百分比为37.3(LOO=62.7)。该模型的敏感性为48.4%,特异性为71.9%。这些结果提供了初步证据,表明机器学习的预测能力可能允许设计标准的患者档案,这有助于为有抑郁和焦虑症状的患者提供更个性化的护理。此外,在MBCT项目中包括更多的心理教育可以最大限度地提高临床效益和坚持这种疗法。然而,还需要进一步的研究来更详细地探讨这个主题。
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Predictive Factors of Response to Mindfulness-Based Cognitive Therapy (Mbct) for Patients with Depressive Symptoms: The Machine Learning’s Point of View
While there is abundant literature on the benefits of Mindfulness-Based Interventions (MBI), data about factors associated with their Efficiency are scarce. Our study attempts to determine the moderators of efficacy and adherence in Mindfulness-Based Cognitive Therapy (MBCT) with a machine learning analysis. Seventy-six psychiatric outpatients at “university hospital mental health service” had a prescription for MBCT from their referring psychiatrist. They suffer from various psychiatric illnesses with depressive symptoms. They completed a battery of clinical, mindfulness, and psychological functioning self-report questionnaires before and after the MBCT intervention of 8 sessions. Changes (after minus before) in scores were used for efficacy. Scores before MBCT were used to study the adherent profile (8 sessions of MBCT) versus non-adherent patients (stopping MBCT before the eight sessions). For efficacy and adherence profiles, machine learning analysis based on the support vector machine (SMV) method was applied to complement classical statistical analyses. Results: For efficacy factors, the SVM analysis finds a two-dimensional profile of patients. The patients for whom MBCT is most effective are patients with a high Beck score (>25) and high trait mindfulness (FFMQ >90). The percentage of misclassified validation examples is 24.6 (LOO = 75.4). The model's sensitivity is 79.3%, and the specificity is 71.9%. For adherence factors, a three-dimensional model is found. The patients who perform the 8 sessions of the MBCT have a profile with high or low trait mindfulness, high or low bodily dissociation, and low self-compassion. The percentage of misclassified validation examples is 37.3 (LOO = 62.7). The model's sensitivity is 48.4%, and the specificity is 71.9%. These results provide preliminary evidence that the predictive power of machine learning may allow the designing of standard patient profiles, which can contribute to 3 more personalized care for patients with symptoms of depression and anxiety. Also, including more psychoeducation in MBCT programs can maximize clinical benefits and adherence to this therapy. However, further studies are needed to explore this topic in more detail.
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