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首页> 外文期刊>The journal of clinical psychiatry >A randomized controlled trial of psychoeducation or cognitive-behavioral therapy in bipolar disorder: A Canadian Network for Mood and Anxiety Treatments (CANMAT) study
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A randomized controlled trial of psychoeducation or cognitive-behavioral therapy in bipolar disorder: A Canadian Network for Mood and Anxiety Treatments (CANMAT) study

机译：双相情感障碍的心理教育或认知行为治疗的随机对照试验：加拿大情绪和焦虑治疗网络（CANMAT）研究

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Objective: Bipolar disorder is insufficiently controlled by medication, so several adjunctive psychosocial interventions have been tested. Few studies have compared these psychosocial treatments, all of which are lengthy, expensive, and difficult to disseminate. We compared the relative effectiveness of a brief psychoeducation group intervention to a more comprehensive and longer individual cognitive-behavioral therapy intervention, measuring longitudinal outcome in mood burden in bipolar disorder. Method: This single-blind randomized controlled trial was conducted between June 2002 and September 2006. A total of 204 participants (ages 18-64 years) with DSM-IV bipolar disorder type I or II participated from 4 Canadian academic centers. Subjects were recruited via advertisements or physician referral when well or minimally symptomatic, with few exclusionary criteria to enhance generalizability. Participants were assigned to receive either 20 individual sessions of cognitive-behavioral therapy or 6 sessions of group psychoeducation. The primary outcome of symptom course and morbidity was assessed prospectively over 72 weeks using the Longitudinal Interval Follow-up Evaluation, which yields depression and mania symptom burden scores for each week. Results: Both treatments had similar outcomes with respect to reduction of symptom burden and the likelihood of relapse. Eight percent of subjects dropped out prior to receiving psychoeducation, while 64% were treatment completers; rates were similar for cognitive-behavioral therapy (6% and 66%, respectively). Psychoeducation cost $180 per subject compared to cognitive-behavioral therapy at $1,200 per subject. Conclusions: Despite longer treatment duration and individualized treatment, cognitive-behavioral therapy did not show a significantly greater clinical benefit compared to group psychoeducation. Psychoeducation is less expensive to provide and requires less clinician training to deliver, suggesting its comparative attractiveness. Trial Registration: ClinicalTrials.gov identifier: NCT00188838
机译：目的：双相情感障碍不能通过药物控制，因此已经对几种辅助性社会心理干预措施进行了测试。很少有研究比较过这些心理社会治疗方法，它们都是冗长，昂贵且难以传播的。我们比较了简短的心理教育小组干预与更全面，更长的个体认知行为治疗干预的相对有效性，该干预措施测量了躁郁症的情绪负担的纵向结果。方法：该单盲随机对照试验于2002年6月至2006年9月进行。来自加拿大4个学术中心的204例I型或II型DSM-IV型双相情感障碍患者参加了研究（年龄18-64岁）。在症状良好或极少出现症状时，通过广告或医生转介招募受试者，几乎没有排除标准可增强普遍性。参加者被分配接受20次认知行为疗法的单独课程或6次团体心理教育的课程。使用纵向间隔随访评估，对症状过程和发病率的主要结局进行了72周的前瞻性评估，得出每周抑郁和躁狂症状负担评分。结果：就减轻症状负担和复发可能性而言，两种治疗均具有相似的结果。 8％的受试者在接受心理教育之前就辍学了，而64％的人是治疗完成者;认知行为治疗的发生率相似（分别为6％和66％）。心理教育的费用为每位受试者180美元，而认知行为疗法的费用为每位1,200美元。结论：尽管治疗时间较长且个体化治疗，但认知行为疗法与团体心理教育相比并未显示出明显更大的临床获益。提供心理教育的费用较低，并且提供的临床医生培训较少，表明其相对具有吸引力。试验注册：ClinicalTrials.gov标识符：NCT00188838

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