مدل سازی دینامیکی اثربخشی درمان های شناختی رفتاری موج سوم و داروهای ضدافسردگی بر اختلال افسردگی اساسی

نویسندگان
سید اسماعیل حسینی 1
محمد پویان 2
علیرضا ولیزاده 3
علیرضا مرادی 4
1 پژوهشکده علوم شناختی، تهران، ایران.
2 دانشکده مهندسی، دانشگاه شاهد، تهران، ایران.
3 دانشکده فیزیک، دانشگاه تحصیلات تکمیلی علوم پایه، زنجان، ایران.
4 دانشکده علوم تربیتی، دانشگاه خوارزمی، تهران، ایران.
10.52547/rph.12.4.16
چکیده
مطالعه­ی دوره­های افسردگی اساسی و عوامل مؤثر بر آن­ها، برای درک ماهیت این اختلال و تدوین راهبرد درمانی مؤثرتر، ضروری است. مدت زمان تقریبی دیرش یک دوره اختلال­افسردگی ­اساسی به صورت متوسط بین 3 تا 12 ماه است؛ درحالی­که این نسبت برای دوره‌های مزمن تا 24 ماه طول می‌کشد. هدف این پژوهش، مدل­سازی دینامیکی نحوه­ی تأثیر داروهای ضد افسردگی و درمان­های شناختی رفتاری موج سوم، بر دوره‏ های اختلال افسردگی، با استفاده از مدل دینامیکی مرتبه دوم بود. با استفاده از برنامه­ نویسی متلب و تغییر پارامترهای مدل، که هر کدام بیانگر یک عامل مؤثر در اختلال­ افسردگی است، نحوه­ی تأثیر درمان­ها، بر روی دوره ‏های ­افسردگی بیماران، در بازه­ی زمانی یک عمر طبیعی 64 ساله، مدل­ سازی شد. دوره­های افسردگی اساسی، قبل و بعد از درمان با داروهای ضد­افسردگی نظیر ایمی­پرامین ویا معادل آن و درمان به­روش تعهد و پذیرش مبتنی بر توجه ­آگاهی و رفتار­درمانی­ دیالکتیکی، برای بیمارانی، که به مدت 14 هفته خدمات درمانی، دریافت کردند، به دست آمد. یافته­ها نشان ­داد، برای بیشتر افراد دارای اختلال­ افسردگی­ اساسی، عود پس از بهبودی، پدیده‌ای رایج است. مدت زمان بهبودی از افسردگی، در شرایط عدم دریافت درمان، بیش از 144 ماه، با دریافت داروهای ضد­افسردگی 71 ماه، با رفتاردرمانی دیالکتیکی 68 ماه، و برای ترکیب مداخله داروهای ضد­افسردگی و رفتار­درمانی ­دیالکتیکی 59 ماه، است. نتایج مدل­سازی دینامیکی نشان ­داد، که ترکیب دو مداخله، روش تعهد و پذیرش همراه با رفتار­درمانی­ دیالکتیکی و درمان دارویی، نتایج بهتری در درمان افسردگی و پیشگیری از عود دارد. این روش ترکیبی، در حدود 10 ماه، مدت زمان لازم برای بهبودی از افسردگی را کاهش می­دهد.
کلیدواژه‌ها
اختلال افسردگی اساسی
مدل سیستم‌های دینامیکی
داروهای ضد‌افسردگی
درمان شناختی رفتاری موج سوم

عنوان مقاله English

Dynamic Modeling of the Effectiveness of Third Wave Cognitive Behavioral Therapy and Antidepressants Drugs on Major Depressive Disorder.

نویسندگان English

Seyed Esmaeil Hosseini 1
Mohammad Pooyan 2
Alireza Valizadeh 3
Alireza Moradi 4
چکیده English

Studying major depressive disorders and related factors is necessary to understand the nature of this disorder and to formulate more effective therapeutic strategies. Approximate duration of one episode of major depressive disorder is averagely between 3 to 12 months; however, in chronic types, the ratio would be prolonged to 24 months. The aime of this research which performed through second-order dynamic model was to investigate the effectiveness of antidepressants and third wave cognitive-behavioral therapies on the duration of any episode of major depressive disorder. Through MATLAB programming and changing the model parameters, we investigate the effectiveness of treatments on duration of episode in major depressive disorder. The average age of any participants were considered 64 years old. Outcomes before and after 14 weeks treatment with antidepressants drugs (as imipramine or its equivalent of therapeutic services) and psychotherapies (included mindfulness-based acceptance and commitment therapty [ACT] and dialectical behavior therapy [DBT]) were obtained. According to the findings, for most of people suffering from major depressive disorder, relapses are prevalent phenomena. Depression relapse time durations have been 144, 71, 68, and 59 months respectively under following conditions: receiving no treatment; receiving untidepressants; receiving dialectical behavior therapy; and, receiving a combination of antidepressants and dialectical behavior therapy. The results from dynamic modeling showed that combined method of ACT, DBT, and using antidepressant (or its equivalant) drugs provides better outcomes in treatment for depression and relapse prevention. This combined method reduced the duration of recovery from depression by 10 months.

کلیدواژه‌ها English

Major Depressive Disorder
Dynamic Systems Model
Antidepressants Drugs
Third Wave Cognitive Behavioral Therapy
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