中度抑郁症治疗反应的预测因素

A. G. Bastos, L. S. Guimarães, C. Trentini
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引用次数: 11

摘要

目的:确定神经认知和社会人口学变量,这些变量可能与抑郁症三种治疗方式的临床反应有关,以及预测一种治疗方法优于其他治疗方法的变量。方法:本研究来源于一项研究项目,在该项目中,272名抑郁症患者接受了三种治疗方法中的一种,即长期心理动力治疗(90名)、氟西汀治疗(91名)或两者联合治疗(91名),持续时间为24个月。结果:未发现社会人口学变量具有预测作用。六个预测神经认知变量:三个预测变量与工作记忆和抽象推理有关;一个与工作记忆有关的规定性变量;有两个变量是调节因子。结论:本研究的结果表明,亚组患者可能受益于特定的治疗策略,而亚组患者似乎对长期心理动力学心理治疗和联合治疗反应良好。调节者发现,抽象推理和处理速度可能影响临床改善的幅度和/或方向。
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Predictors of response in the treatment of moderate depression
Objective: To identify neurocognitive and sociodemographic variables that could be associated with clinical response to three modalities of treatment for depression, as well as variables that predicted superior response to one treatment over the others. Method: The present study derives from a research project in which depressed patients (n=272) received one of three treatments – long-term psychodynamic psychotherapy (n=90), fluoxetine therapy (n=91), or a combination thereof (n=91) – over a 24-month period. Results: Sociodemographic variables were not found to be predictive. Six predictive neurocognitive variables were identified: three prognostic variables related to working memory and abstract reasoning; one prescriptive variable related to working memory; and two variables found to be moderators. Conclusions: The results of this study indicate subgroups of patients who might benefit from specific therapeutic strategies and subgroups that seem to respond well to long-term psychodynamic psychotherapy and combined therapy. The moderators found suggest that abstract reasoning and processing speed may influence the magnitude and/or direction of clinical improvement.
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