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首页> 外文期刊>The journal of clinical psychiatry >Interpersonal psychotherapy and antidepressant medication: evaluation of a sequential treatment strategy in women with recurrent major depression.
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Interpersonal psychotherapy and antidepressant medication: evaluation of a sequential treatment strategy in women with recurrent major depression.

机译：人际心理治疗和抗抑郁药：复发性重度抑郁症妇女的序贯治疗策略评估。

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BACKGROUND: Few data are available to guide treatment selection in major depression. With increasing pressure to maximize the efficiency and minimize the costs of treatment, it is important to have information that could guide treatment selection or point to treatment strategies that have a high probability of success. METHOD: We used a successive cohort approach to compare 2 highly similar groups of women with recurrent unipolar disorder (DSM-III-R or DSM-IV): one in which the combination of interpersonal psychotherapy (IPT) and pharmacotherapy was initiated at the outset of treatment and a second in which IPT alone was provided first and only those who did not remit with IPT alone were offered the combination treatment. RESULTS: In the group in which the combination was initiated at the outset of treatment (N = 180), the remission rate was 66%, comparable to the remission rate observed in most outpatient treatment studies of major depression. In contrast, among the women in the second cohort who were first treated with IPT alone and only those who did not remit were given combination therapy (N = 159), the remission rate was 79%, significantly greater than that observed in the group that received combination treatment from the outset (chi2 = 6.55, p = .02). CONCLUSION: These results suggest that the strategy of offering IPT to women with recurrent unipolar disorder and, in the absence of remission, adding antidepressant pharmacotherapy can be a highly effective treatment, one that may be particularly attractive to women in the childbearing years. Although slower in its onset of action, this sequential strategy is likely to enable the clear majority of such women to achieve a full remission of depressive symptoms.
机译：背景：很少有数据可指导重度抑郁症的治疗选择。随着使效率最大化和治疗成本最小化的压力越来越大，重要的是要获得可以指导治疗选择或指出具有高成功可能性的治疗策略的信息。方法：我们采用连续队列研究方法比较了两类高度相似的复发性单相情感障碍妇女（DSM-III-R或DSM-IV）：其中一开始就采用了人际心理治疗（IPT）和药物治疗相结合的方法第二种治疗方法是首先提供单独的IPT，仅向那些不单独使用IPT进行治疗的患者提供联合治疗。结果：在治疗开始时开始联合使用的组（N = 180），缓解率为66％，与大多数重度抑郁症的门诊治疗研究中观察到的缓解率相当。相比之下，第二组首次单独接受IPT治疗且仅未缓解的妇女接受了联合疗法（N = 159），其缓解率为79％，明显高于该组中观察到的从一开始就接受联合治疗（chi2 = 6.55，p = .02）。结论：这些结果表明，为复发性单相情感障碍妇女提供IPT的策略，并且在没有缓解的情况下，增加抗抑郁药物治疗可能是一种非常有效的治疗方法，可能对育龄妇女特别有吸引力。尽管起效较慢，但这种循序渐进的策略很可能使绝大多数这类妇女能够完全缓解抑郁症状。

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