当前位置: X-MOL 学术Psychother. Psychosom. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
The Importance of Symptom Reduction for Functional Improvement after Cognitive Behavioral Therapy for Anxiety and Depression: A Causal Mediation Analysis.
Psychotherapy and Psychosomatics ( IF 22.8 ) Pub Date : 2023-05-24 , DOI: 10.1159/000530650
Otto R F Smith 1, 2, 3 , Leif E Aarø 1 , Marit Knapstad 1
Affiliation  

INTRODUCTION The temporal relationship between symptoms and functioning in the context of cognitive behavioral therapy (CBT) for anxiety and depression is not fully understood, and there are few high-quality studies that have examined to what extent late intervention effects of CBT on functioning are mediated by initial intervention effects on symptoms while accounting for the initial effects on functioning and vice versa. OBJECTIVE The aim of the study was to investigate whether intervention effects on symptoms and functioning at 12-month follow-up were mediated by intervention effects on these outcomes at 6-month follow-up. METHODS Participants with anxiety and/or mild-to-moderate depression were randomly assigned to a primary mental health care service (n = 463) or treatment-as-usual (n = 215). Main outcomes were depressive symptoms (Patient Health Questionnaire [PHQ-9]), anxiety (General Anxiety Disorder-7 [GAD-7]), and functioning (Work and Social Adjustment Scale [WSAS]). Direct/indirect effects were derived using the potential outcomes and counterfactual framework. RESULTS The intervention effect on functioning at 12 months was largely explained by intervention effects at 6 months on depressive symptoms (51%) and functioning (39%). The intervention effect on depressive symptoms at 12 months was largely explained by the intervention effect at 6 months on depressive symptoms (70%) but not by functioning at 6 months. The intervention effect on anxiety at 12 months was only partly accounted for by intervention effects at 6 months on anxiety (29%) and functioning (10%). CONCLUSIONS The findings suggest that late intervention effects of CBT on functioning were to a substantial degree explained by initial intervention effects on depressive symptoms even after accounting for initial effects on functioning. Our results support the importance of symptoms as an outcome in the context of CBT delivered in primary health care.

中文翻译:

焦虑和抑郁认知行为疗法后症状减轻对功能改善的重要性:因果中介分析。

引言 在认知行为疗法(CBT)治疗焦虑和抑郁的背景下,症状和功能之间的时间关系尚未完全了解,并且很少有高质量的研究来检验 CBT 对功能的后期干预作用在多大程度上得到介导通过对症状的初始干预影响,同时考虑对功能的初始影响,反之亦然。目的 该研究的目的是调查干预对 12 个月随访时症状和功能的影响是否是由干预对 6 个月随访时结果的影响所介导的。方法 患有焦虑和/或轻度至中度抑郁症的参与者被随机分配至初级心理保健服务机构 (n = 463) 或接受常规治疗 (n = 215)。主要结果是抑郁症状(患者健康问卷 [PHQ-9])、焦虑(一般性焦虑症-7 [GAD-7])和功能(工作和社会适应量表 [WSAS])。使用潜在结果和反事实框架得出直接/间接影响。结果 12 个月时的干预对功能的影响很大程度上可以通过 6 个月时对抑郁症状 (51%) 和功能 (39%) 的干预效果来解释。12 个月时对抑郁症状的干预效果很大程度上可以通过 6 个月时对抑郁症状的干预效果 (70%) 来解释,而不是通过 6 个月时的功能来解释。12 个月时对焦虑的干预效果仅部分归因于 6 个月时对焦虑 (29%) 和功能 (10%) 的干预效果。结论 研究结果表明,即使在考虑了对功能的初始影响之后,CBT 对功能的后期干预效应在很大程度上可以通过对抑郁症状的初始干预效应来解释。我们的结果支持了在初级卫生保健中提供 CBT 的背景下症状作为结果的重要性。
更新日期:2023-05-24
down
wechat
bug