The Research Of Cognitive Behavior Therapy For Treatment-resistant Depression

Recently, many therapeutic studies pay more attention to treatment-resistant depression (TRD). Combination therapy is commonly recommended. Psychotherapy is one of considerable combination therapy plans. Many studies focus on cognitive behavior therapy (CBT) which is effective psychotherapeutic method for treatment-resistant depression in many psychotherapeutic schools. However, no favorable random controlled trial (RCT) demonstrated its efficacy. Moreover, there is no domestic research about psychotherapy for TRD. Therefore, it is essential to demonstrate its efficacy and explore it.OBJECTIVES1. To demonstrate the efficacy of cognitive behavior therapy (CBT) for treatment-resistant depression.2. To explore the influential factors for the efficacy.3. To explore the characteristic of treatment-resistant depression that is more suitable to the combination of cognitive behavior therapy and venlafaxine.METHOD1. With the help of foreign literature of cognitive behavior therapy, a handbook of cognitive behavior therapy for treatment-resistant depression is developed.2. According to territory feature,six mental health centers in China were chosen, and prospective stratified random controlled trial and cohort study were adopted.3. It is carried out by two steps, one is to find the patients of treatment-resistant depression; the other step is the therapeutics study that four therapeutic plans are randomly adopted to the patients.RESULTS1. The total efficacy in the combination of venlafaxine and cognitive behavior therapy (0.06104±0.0483) is superior to the combination of venlafaxine and Lithium (0.5478±0.0719), or venlafaxine and atypical antipsychotic (0.4709±0.0574).2. Contrasting the patients older than 35 with the patients younger than 35, no statistics difference between the combination of venlafaxine and cognitive behavior therapy, the combination of venlafaxine and electroconvulsive therapy and the combination of venlafaxine and Lithium. (P＞0.05).3. In the patients with cultural degree in the senior high school or above cultural degree in the senior high school, a significant difference is found between the combination of cognitive behavior therapy and any other combination plan. (P＜0.05)4. For the patients (≥32 in life event scale), the efficacy of the combination of venlafaxine and cognitive behavior therapy is superior to the combination of venlafaxine and Lithium, or venlafaxine and atypical antipsychotic.CONCLUSION1. The combination of venlafaxine and cognitive behavior therapy is one of the optimized therapeutic plans for treatment-resistant depression.2. For the patients with outstanding life events, we should initially adopt the combination of venlafaxine and cognitive behavior therapy.3. For the patients with cultural degree in the senior high school or above cultural degree in the senior high school, we should initially adopt the combination of venlafaxine and cognitive behavior therapy.4. The handbook of cognitive behavior therapy for treatment-resistant depression developed by us is effective.