认知行为疗法治疗成人精神障碍的有效性：一项横跨29所大学门诊诊所的大规模自然主义研究

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy Pub Date : 2025-01-23 DOI:10.1016/j.brat.2025.104691

Julia Velten , Hanna Christiansen , Jürgen Hoyer , Tina In-Albon , Tania Lincoln , Wolfgang Lutz , Jürgen Margraf , Henning Schöttke , Rudolf Stark , Katja Werheid , Ulrike Willutzki , Georg W. Alpers , Stephan Bartholdy , Elisa-Maria Berger , Eva-Lotta Brakemeier , Anne-Kathrin Bräscher , Timo Brockmeyer , Isabel Dziobek , Lydia Fehm , Thomas Forkmann , Julian A. Rubel

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引用次数: 0

摘要

基于实践的证据已成为对照试验研究的重要补充范式。本文介绍了德国大学门诊诊所的大型研究实践网络的结果；柯达计划。在2023年至2014年期间，在29家心理治疗门诊诊所接受治疗的6624名成人患者的异质临床样本中，报告了前后效应大小、变化的直接评估以及临床显着和可靠的改善率。临床诊断，在所有诊所的基线上通过结构化的诊断性临床访谈确定，包括广泛的精神病理学。有效性与自然环境下的其他研究相当（d≈0.75-0.95），略低于疾病特异性CBT疗效试验报告的变化。在直接评估变化时，只有1.9%的患者报告症状恶化，3.4%的患者报告治疗期间无变化。总的来说，结果显示了多地点自然主义研究计划的潜力，特别是德国大学门诊CBT的有效性。

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Effectiveness of cognitive behavioral therapy for adult mental disorders: A large-scale naturalistic study across 29 university outpatient clinics

Practice-based evidence has emerged as an important complementary paradigm to studies in controlled trials. This paper presents results of a large research-practice network at German university outpatient clinics; the KODAP initiative. Pre-post effect sizes, direct assessments of change, and rates of clinically significant and reliable improvement are reported in a heterogeneous clinical sample of 6624 adult patients treated between 2023 and 2014 in 29 psychotherapeutic outpatient clinics. Clinical diagnoses, determined with structured diagnostic clinical interviews at baseline across all clinics, encompassed a wide range of psychopathology. Effectiveness was comparable to other studies in naturalistic settings (d ≈ 0.75–0.95) and somewhat lower than changes reported in disorder-specific CBT efficacy trials. In direct assessments of change, only 1.9% of the patients reported symptom worsening and 3.4% reported no change during treatment. Overall, the results show the potential of multi-site naturalistic research initiatives in general and the effectiveness of outpatient CBT at German university outpatient clinics in particular.

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来源期刊

Behaviour Research and Therapy PSYCHOLOGY, CLINICAL-

CiteScore

7.50

自引率

7.30%

发文量

148

期刊介绍： The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.