Introduction: Major depressive disorder (MDD) is a highly prevalent and disabling disorder. This study examines two psychotherapy methods for MDD, behavioral activation (BA), and metacognitive therapy (MCT), when applied as outpatient treatments to severely affected patients. Methods: The study was conducted in a tertiary outpatient treatment center. Patients with a primary diagnosis of MDD (N = 122) were included in the intention-to-treat sample (55.7% female, mean age 41.9 years). Participants received one individual and one group session weekly for 6 months (M). Assessments took place at baseline, pretreatment, mid-treatment (3 M), post-treatment (6 M), and follow-up (12 M). The primary outcome was depressive symptomatology assessed by the Hamilton Rating Scale for Depression at 12 M follow-up. Secondary outcomes included general symptom severity, psychosocial functioning, and quality of life. Results: Linear mixed models indicated a change in depressive symptoms (F(2, 83.495) = 12.253, p #x3c; 0.001) but no between-group effect (F(1, 97.352) = 0.183, p = 0.670). Within-group effect sizes were medium for MCT (post-treatment: d = 0.610; follow-up: d = 0.692) and small to medium for BA (post-treatment: d = 0.636, follow-up: d = 0.326). In secondary outcomes, there were improvements (p ≤ 0.040) with medium to large within-group effect sizes (d ≥ 0.501) but no between-group effects (p ≥ 0.304). Response and remission rates did not differ between conditions at follow-up (response MCT: 12.9%, BA: 13.3%, remission MCT: 9.7%, BA: 10.0%). The deterioration rate was lower in MCT than in BA (χ²₁ = 5.466, p = 0.019, NTT = 7.4). Discussion: Both MCT and BA showed symptom reductions. Remission and response rates were lower than in previous studies, highlighting the need for further improvements in adapting/implementing treatments for severely affected patients with MDD.
Psychother Psychosom

中文翻译：

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元认知疗法与行为激活疗法相比对重度抑郁门诊患者的有效性：一项单中心随机试验

简介：重度抑郁症 (MDD) 是一种非常普遍且致残的疾病。本研究检验了 MDD、行为激活 (BA) 和元认知疗法 (MCT) 的两种心理治疗方法，当它们作为门诊治疗应用于严重受影响的患者时。方法：该研究在三级门诊治疗中心进行。初步诊断为 MDD 的患者 ( N= 122) 被纳入意向治疗样本（55.7% 为女性，平均年龄 41.9 岁）。参与者每周接受一次个人和一次小组会议，持续 6 个月 (M)。评估发生在基线、治疗前、治疗中期 (3 M)、治疗后 (6 M) 和随访 (12 M)。主要结果是在 12 M 随访时通过汉密尔顿抑郁量表评估的抑郁症状。次要结果包括一般症状严重程度、社会心理功能和生活质量。结果：线性混合模型表明抑郁症状发生变化 ( F (2, 83.495) = 12.253, p #x3c; 0.001) 但没有组间效应 ( F (1, 97.352) = 0.183, p= 0.670）。MCT 的组内效应大小为中等（治疗后：d = 0.610；随访：d = 0.692），BA 的组内效应大小为中等（治疗后：d = 0.636，随访：d = 0.326）。在次要结果中，有改善 ( p ≤ 0.040)，组内效应大小为中等至较大 ( d ≥ 0.501)，但没有组间效应 ( p ≥ 0.304)。响应和缓解率在后续条件之间没有差异（响应 MCT：12.9%，BA：13.3%，缓解 MCT：9.7%，BA：10.0%）。MCT 的恶化率低于 BA (χ ² ₁ = 5.466, p = 0.019, NTT = 7.4)。讨论：MCT 和 BA 均显示症状减轻。缓解率和反应率低于之前的研究，突出表明需要进一步改进对严重受影响的 MDD 患者的适应/实施治疗。
心理医生