Predictors of Treatment Effectiveness of Cognitive Behavioral Therapy for Depression

• Project/Area Number: 18K13329
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 10030:Clinical psychology-related
• Research Institution: Keio University
• Principal Investigator: MITSUDA Dai 慶應義塾大学, 医学部(信濃町), 特任助教 (80782226)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000); Fiscal Year 2020: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2019: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2018: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
• Keywords: うつ病 / 認知行動療法 / 治療予測因子 / 治療効果予測

Outline of Final Research Achievements

Cognitive-behavioral therapy, one of the treatments for depression, is considered to be effective, but its effectiveness varies from person to person. One of the factors that cause individual differences is the relationship between the way depressive symptoms improve and the effectiveness of the treatment.
In the present study, we examined how much improvement in depressive symptoms at what point in the course of cognitive-behavioral therapy for depression could be used to predict the effectiveness at the end of cognitive-behavioral therapy. The results suggested that a QIDS score of 10 points or less at 10 weeks after the start of treatment, which is a little after the turn of treatment, or a score decrease of 62% or more from the start to 10 weeks, predicted remission (almost no symptoms) at the end of cognitive behavioral therapy with high probability.

Academic Significance and Societal Importance of the Research Achievements

本研究の結果、うつ尺度であるQIDS得点と治療開始時からの得点減少率のいずれにおいても、認知行動療法の折り返しをすぎたあたりである、治療開始後10週時点が、認知行動療法終了時の効果予測をするのに最適な週数と同定された。
このことは、認知行動療法開始から折り返し地点あたりにかけての一定のうつ症状の改善がその後の治療成績に関連することが示唆されたことを示している。また、10週までに十分な改善が認められない場合には、この時点でのQIDS得点や得点減少率が、治療方針の変更など臨床判断を下す際の一つの指標として活用されることが期待される。

Research Products

• [Journal Article] うつ病の認知行動療法の適応とその効果・限界 (2021)
  • Author(s): 伊原栄・満田大・中川敦夫
  • Journal Title: 精神科 Volume: 38 Pages: 6-11
• [Journal Article] Neural and Clinical Changes of Cognitive Behavioural Therapy Versus Talking Control in Patients With Major Depression: A Study Protocol for a Randomised Clinical Trial (2020)
  • Author(s): Nariko Katayama, Atsuo Nakagawa, Chika Kurata, Yohei Sasaki, Dai Mitsuda, Shigetsugu Nakao, Sayuri Mizuno, Mire Ozawa, Yuko Nakagawa, Natsumi Ishikawa, Satoshi Umeda, Yuri Terasawa, Hajime Tabuchi, Toshiaki Kikuchi, Takayuki Abe, Masaru Mimura
  • Journal Title: BMJ Open Volume: 10 Issue: 2 Pages: e029735-e029735
  • DOI: 10.1136/bmjopen-2019-029735
  • Peer Reviewed / Open Access
• [Journal Article] 治療抵抗性うつ病に対する認知行動療法 (2020)
  • Author(s): 満田大・野上和香・中川敦夫
  • Journal Title: 医学のあゆみ Volume: 5 Pages: 461-465
• [Journal Article] Web-Based Cognitive Behavioral Therapy Blended With Face-to-Face Sessions for Major Depression: Randomized Controlled Trial (2018)
  • Author(s): Nakao Shigetsugu、Nakagawa Atsuo、Oguchi Yoshiyo、Mitsuda Dai、Kato Noriko、Nakagawa Yuko、Tamura Noriko、Kudo Yuka、Abe Takayuki、Hiyama Mitsunori、Iwashita Satoru、Ono Yutaka、Mimura Masaru
  • Journal Title: Journal of Medical Internet Research Volume: 20 Issue: 9 Pages: e10743-e10743
  • DOI: 10.2196/10743
  • Peer Reviewed / Open Access
• [Presentation] うつ病に対する認知行動療法における効果発現時期の予測因子の検討 －治療中間時点におけるうつ評価尺度からの検討－ (2019)
  • Author(s): 満田大・中川敦夫
  • Organizer: 日本認知療法・認知行動療法学会