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Yıl:2015; Cilt: 5; Sayı: 3>> Özet
TAM METİN
Journal of Mood Disorders; 2015;5(3):104-112
Yatarak tedavi gören depresif bozukluk olgularında farmakoterapi tedavisine ek olarak grup davranış aktivasyon tedavisinin etkinliği
S Fereidooni, B Gharaei, B Birashk, A Sahraeian, SMD Hoseini
Shiraz University of Medical Sciences,Shiraz, Iran
Amaç: Depresyon ile baş etme yöntemlerinin tarihini göz önüne almak önemlidir ki davranış aktivasyonu (DA) [bu yazının odaklandığı] davranışçı yaklaşımlardan gelişmiştir. Fakat güncel DA hem danışanın ihtiyaç ve hedeflerini açıklayan hem de depresif davranış ve mizacı destekleyen çevresel tesadüfleri belirleyen idiyografik, işlevsel bir yaklaşım sağlar. Bu çalışmanın amacı depresif bozukluk nedeniyle yatan hastalarda farmakoterapi tedavisine ek olarak Grup Davranış Aktivasyon Tedavisi (GDAT)’nin etkinliğini değerlendirmektir. Yöntem: Bu çalışma bir klinik araştırma çalışmasıdır. SCID-I’e göre depresif bozukluk tanısı alan, çalışmaya katılmayı kabul eden, Shiraz Psikiyatri Hastanesinde 2010 yaz ayında yatarak tedavi gören 24 olgu çalışmaya dahil edildi. Olgular rastgele müdahale, kontrol ve plasebo olmak üzere 3 gruba ayrıldı. Birinci gruba GDAT uygulandı. Terapistin dikkatinin etkinliğini kontrol etmek için üçüncü grup ayrıca videoları izledi. Tüm olgular Beck depresyon ölçeği-II (BDÖ-II) ve Depresyon için DA ölçeği doldurdu. Bulgular: Tekrar eden ölçümlerin değişken analiz sonuçlarına göre; her üç grupta da BDÖ-II sonuçlarına göre ilk ve 2. aylık takibinde aynı şekilde anlamlı azalma gözlendi, fakat gruplar arasında istatistiki olarak anlamlı farklılık gözlenmedi. Ancak BDÖ-II analiz sonuçlarına göre Davranış aktivasyon terapisi hastaların depresyonunu azaltmada etkili bulunmuştur (F=11.27, p=0.001). GDAT analiz sonuçlarına göre hastaların depresyonu anlamlı olarak azalmıştır (F=105.97, p=0.001).v Sonuç: Bizim sonuçlarımız GDAT’nin yatarak tedavi gören depresyon hastalarında destekleyici olarak ilaç tedavisinin etkinliğini arttırdığını göstermiştir. Küçük örneklem büyüklüğü ve mevcut bulguların genelleştirilmesindeki sınırlılıklar nedeniyle bu sonuçlar için dikkatli olunmalıdır. Anahtar Kelimeler:
Efficacy of group behavioral activation treatment as supplemental treatment to pharmacotherapy in inpatients with depressive disorders
Objective: It is important to consider history of dealing with depression as it evolved from pure behavioral approaches that predate behavioral activation. Current behavioral activation adds an idiographic and functional approaches, which explores client’s needs, goals and environmental contingencies that support depressive behaviors and moods. The aim of this study is to evaluate efficacy of Group Behavioral Activation Treatment (GBAT) as a supplemental treatment to pharmacotherapy in inpatients suffering from depressive disorders. Methods: This is a clinical trial. We included 24 patients with depressive disorders (according to SCID-I), who were admitted to Shiraz Psychiatric Hospital in summer 2010. They were randomly divided into three groups: intervention, control, and placebo. All three groups prescribed their usual pharmacological treatment. Additionally, first group was treated with GBAT. In order to control the efficacy of therapist’s attention, third group watched video-movie as well. All participants completed Beck Depression Inventory-II (BDI-II) and Behavioral Activation for Depression Scale (BADS). Results: According to the results of the analysis of variance for repeated measures: all 3 groups showed same decrease in post and 2 mounts follow-up in BDI-II, however there was no significant difference among groups. Nevertheless, based on the results of analysis for BDI-II, it is indicated that behavioral activation therapy has been effective in decreasing depression of patients (F=11.27; p=0.001). Results indicated that based on the analysis of BADS, patients’ depression has significantly decreased (F=105.97; p=0.001). Conclusions: Our research findings indicate that using the GBAT as a supplemental treatment for depressed inpatients can increase the effectiveness of medication therapy. Small sample size and cautions in the generalization of the present findings to be noted. Key words:

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