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首页> 外文期刊>BMC Psychiatry >Identifying the most suitable treatment for depression based on patients’ attachment: study protocol for a randomized controlled trial of supportive-expressive vs. supportive treatments
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Identifying the most suitable treatment for depression based on patients’ attachment: study protocol for a randomized controlled trial of supportive-expressive vs. supportive treatments

机译：根据患者的依恋关系确定最适合的抑郁症治疗方法：一项关于支持性表达与支持性治疗的随机对照试验的研究方案

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In the absence of one intervention that can cure all patients with major depressive disorder (MDD), the leading cause of disability worldwide, increased attention has been focused on selecting the best treatment based on patient characteristics. Theory-driven hypotheses for selecting the best treatments have not yet been adequately investigated. The present study tested the a priory hypothesis that attachment orientations may determine whether patients benefit more from a treatment where alliance provides a facilitative environment for the treatment to work, as in the case of supportive-expressive psychotherapy, vs. where alliance is conceptualized as an active ingredient in itself, as in the case of supportive psychotherapy. To test the hypothesis that attachment orientation moderates the effect of treatment condition on outcome, we conduct a randomized controlled trial (RCT). One hundred patients are randomized to 16 sessions of either supportive-expressive or supportive psychotherapy for MDD, conducted by experienced psychologists. The primary outcome is change in the Hamilton Rating Scale for Depression. Secondary outcome measures include self-reported depressive and other symptoms, psychological and interpersonal functioning, quality of life, and the presence of the diagnosis of depression. Additional measures include hormonal levels, motion synchrony, and acoustic attributes, performance on cognitive tasks, and narrative material (collected from the sessions and from interviews). The RCT will expand our understanding of how the outcome of treatment can be optimized by identifying the most promising role of alliance in treatment, based on patients’ pre-treatment attachment orientation. Results will contribute to the ongoing theoretical debate concerning the differential efficacy of various psychotherapeutic approaches for patients with different attachment orientations. The RCT will also contribute to progress toward personalized treatment by informing therapists about which of two approaches are most effective with patients based on their attachment styles. Clinicaltrials.gov Identifier: NCT02728557 submitted on the 15.3.16. Funding: The Israel Science Foundation. Trial status: Recruitment is ongoing.
机译：在没有一种可以治愈所有严重抑郁症（MDD）（世界范围内致残的主要原因）的干预措施的情况下，越来越多的注意力集中在根据患者特征选择最佳治疗上。选择最佳治疗方法的理论驱动假设尚未得到充分研究。本研究检验了一个先验假说，即依恋倾向可以确定患者是否从一种治疗中受益，而在这种情况下，同盟为支持性心理治疗提供了有利的治疗环境，而同盟被概念化为一种支持性心理治疗。本身就是活性成分，例如支持性心理治疗。为了检验依恋倾向会减轻治疗条件对预后的影响的假设，我们进行了一项随机对照试验（RCT）。将一百名患者随机分配到由经验丰富的心理学家进行的针对MDD的支持性表达或支持性心理治疗的16个疗程。主要结果是汉密尔顿抑郁量表的变化。次要结果指标包括自我报告的抑郁症和其他症状，心理和人际关系功能，生活质量以及是否患有抑郁症。其他措施包括荷尔蒙水平，动作同步性和声学属性，认知任务的表现以及叙述材料（从会议和访谈中收集）。通过根据患者的治疗前依恋取向，确定联盟在治疗中最有希望的作用，RCT将扩大我们对如何优化治疗结果的理解。研究结果将有助于正在进行的有关各种心理治疗方法对具有不同依恋倾向的患者的差异疗效的理论辩论。 RCT还将根据治疗师的依恋方式告知治疗师两种方法中哪种对患者最有效，从而有助于朝着个性化治疗的方向发展。 Clinicaltrials.gov标识符：NCT02728557于15.3.16提交。资金来源：以色列科学基金会。试用状态：招聘正在进行中。

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