A Comparative Study of Cognitive-Behavior Therapy and Paroxetine for Minor Depression_Chinese Journal of Evidence-Based Medicine

Authors：

 SANG Wenhua ¹ , ZHANG Diran ² , TIAN Guoqing ¹ , YU Xuezhu ¹ , LIU Jiancong ¹ , YANG Liaohu ¹ , ZHANG Yanheng ¹

1. The Sixth People’ s Hospital of Hebei Province/ Mental Health Center of Hebei Province, Baoding, 71000, China2. The Second People’ s Hospital of Guizhou Province, Fuquan, 550501, China;

Corresponding author：

SANG Wenhua, Email: whsang997169@163.com

Keywords：

Psychology; Cognitive-behavior therapy; Paroxetine; Depression disorder; Clinical controlled trial

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Objective 　To compare the effects of cognitive-behavior therapy (CBT) and domestic paroxetine in the treatment of minor depression.
Methods 　A therapeutic technique model for the treatment of minor depression was established. Sixty-four patients with minor depression meeting DSM-IV criteria were divided into CBT and paroxetine groups with 32 patients respectively, and were treated for six weeks. The Hamilton Depression Scale (HAMD) was used to evaluate the clinical efficacy and relapse/recrudescence rate of the two groups. Side effects of paroxetine were also recorded.
Results 　At the end of 2 weeks, no significant difference was noted in the reduction of the HAMD score between the two groups. At the end of 6 weeks, there was little difference in thHAMD score reduction between the two groups (F=8.3,P= 0). No significant difference was found in the curative effects between the two groups (u=316.5,P=0.06).In the paroxetine group, cure rate was 20.7%, significant improvement rate was 48.3%; In the CBT group, cure rate was 10.0%, significant improvement rate was 36.7%.The relapse/recrudescence rate after six in the paroxetine group was higher than in cognitive-behavior therapy group at 6 months’ follow-up (u=106.5,P=0.04).
Conclusion　 The clinical efficacy of cognitive-behavior therapy for minor depression seems to be similar to that of paroxetine. The established model of CBT can be used in clinical practice.

Citation： SANG Wenhua,ZHANG Diran,TIAN Guoqing,YU Xuezhu,LIU Jiancong,YANG Liaohu,ZHANG Yanheng. A Comparative Study of Cognitive-Behavior Therapy and Paroxetine for Minor Depression. Chinese Journal of Evidence-Based Medicine, 2007, 07(10): 711-714. doi: Copy

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2.	Shu L. Self_Rating Depression Scale and Depression Status Inventory. Look: Wang XD, Wang XL, Ma H et al. Rating Scales for Mental Health (Revised). Beijing: Publishing House, Chinese Journal of Mental Health, 1999: 194-196.
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1. Huang XQ. Congnitive therapy in treatment of adolescent major depressive disorder: a randomized controlled study. Chengdu, Department of Psychiatry and Mental health, Huaxi Medical Centre, Sichuan university, 2005.
2. Shu L. Self_Rating Depression Scale and Depression Status Inventory. Look: Wang XD, Wang XL, Ma H et al. Rating Scales for Mental Health (Revised). Beijing: Publishing House, Chinese Journal of Mental Health, 1999: 194-196.
3. Tang YH. Hospital Anxity and Depression Scale. Look: Wang XD, Wang XL, Ma H, et al. Rating Scales for Mental Health (Revised).Beijing: Publishing House, Chinese Journal of Mental Health, 1999: 223.
4. Xu JM, Ji JL. Editor-in-Chief. Cognitive psychological treatment. 1stEdition. Guiyang: Publishing House of Guizhou Education, 1999: 30-53.
5. Lyness JM, Heo M, Datto CJ, et al. Outcomes of minor and subsyndromal depression among elderly patients in primary care settings. Ann Intern Med, 2006, 144(7): 496-504.
6. 黄晓琦. 青少年抑郁认知治疗对照研究. 成都: 四川大学华西医学中心精神病与精神卫生学系, 2005.
7. 舒良. 自评抑郁量表和抑郁状态问卷. 见: 汪向东, 王希林, 马弘, 等. 主编. 心理卫生评定量表手册 (增订版). 北京: 中国心理卫生杂志社, 1999: 194-196.
8. 汤毓华. 医院焦虑抑郁量表. 见: 汪向东, 王希林, 马弘, 等. 主编. 心理卫生评定量表手册 (增订版). 北京: 中国心理卫生杂志社, 1999: 223.
9. [美]Michael B. First, Robert L, Spitzer, et al. DSM-Ⅳ-TR 轴Ⅰ障碍用临床定式检查病人版 (SCID-Ⅰ/P) (S). 李涛, 周茹英, 胡峻梅, 等译. 王志青, 杨少杰, 姜春玲, 等更新定稿. 北京回龙观医院临床流行病学研究室, 2004.Michael B. First, Robert L, Spitzer, et al. Structured Cl inical Interview for DSM-Ⅳ-TR Axis ⅠDisorder-patieon Edition Translated by Li T, Zhou RY, Hu JM, et al, Revised by Wang ZQ, Yang SJ, Jiang CL, et al. Department of Clinical Epidemiology, Beijing Huilongguan Hospital, 2004.
10. [美]Judith S Beck博士. 翟书涛, 等译. 认知疗法: 基础与应用. 北京: 中国轻工业出版社, 2001: 15-29.Doctor Beck JS. Translated by Zhai ST, et al. Cognitive Therapy: Basic and Beyond. Beijing: Publishing House of Beijing Light Industry, 2001: 15-29.
11. 徐俊冕, 季建林. 主编. 认知心理治疗. 第1版. 贵阳: 贵州教育出版社, 1999: 30-53.
12. [美]Robert L. Leathy认知治疗技术: 从业者指南. 张黎黎, 陈曦, 聂晶等译. 施承孙女审校. 北京: 中国轻工业出版社, 2005: 7-139.
13. Will iams JW, Barrett J, Oxman T, et al. Treatment of dysthymia and minor depression in primary care: a randomized controlled trial in older adults. JAMA, 2000, 284: 1519-1526.
14. Judd LL, Rapaport MH, Yonkers KA, et al. Randomized, placebo-controlled trial of fluoxetine for acute treatment of minor depressive disorder. Am J Psychiatry, 2004, 161(10): 1864-1871.
15. Pinquart M, Duberstein PR, Lyness JM. Treatments for later-life depressive conditions: a meta-analytic comparison of pharmacotherapy and psychotherapy. Am J Psychiatry, 2006, 163(9): 1493-1501.
16. Goldapple K, Segal Z, Garson C, et al. Modulation of cortical-limbic pathways in major depression: treatment-specific effects of cognitive behavior therapy. Archives of General Psychiatry, 2004, 61(1): 34-41.
17. [英]Sue Mayor. 张新凯, 译. 张明园, 校. 认知行为治疗对大脑活动的影响有别于抗抑郁药. 英国医学杂志中文版, 2004, 7(4): 209. Sue Mayor. Translated by Zhang XK, Revised by Zhang MY. Effect of Cognitive-behavior therapy to cerebrum activity is distinguishable from antidepressant drug. BMJ(Chinese Edition), 2004, 7(4): 209.
18. Williams J, Barrett J, Oxman T, et al. Treatment of dysthymia and minor depression in primary care: a randomized, controlled trial in older adults. JAMA, 2000, 284: 1519-1526.

Chinese Journal of Evidence-Based Medicine

A Comparative Study of Cognitive-Behavior Therapy and Paroxetine for Minor Depression

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