The role of cognitive group therapy and happiness training on cerebral blood flow using ^99mTc-ECD brain perfusion SPECT

Summary

Objective: The purpose of this study is to investigate the impact of cognitive group therapy and happiness training objectively in the local cerebral blood flow of patients with major depression (MD). Patients, material, methods: The present research is semi-experimental to pre- and post-test with a control group. Three groups were formed, and this number was incorporated in each group: 12 patients were chosen randomly; the first group of depressed patients benefited from the combination of pharmacotherapy and sessions of cognitive group therapy; the second group used a combination of pharmaco- therapy and sessions of happiness training; and a third group used only pharmacother- apy. We compared cognitive-behavioural therapy and happiness training efficacy with only pharmacotherapy in MD patients. We performed brain perfusion SPECT in each group, before and after each trial. Results: The study was conducted on 36 patients with MD (32 women and 4 men; mean age: 41.22 ± 9.08; range: 27-65 years). There were significant differences regarding the two trial effects into two experimental groups (p < 0/001) before and after trials, while such differences were not significant in the control group (p > 0.05). In addition, there was significant difference among the regional cerebral blood flow in the frontal and prefrontal regions into two experimental groups before and after trials (p < 0/001), while such differences were not significant in the control group (p > 0.05). Conclusion: This study demonstrated decreased cerebral perfusion in the frontal regions in MD patients, which increased following cognitive group therapy and happiness training. Because of its availability, low costs, easy performance, and the objective semi-quantitative information supplied, brain perfusion SPECT

Zusammenfassung

In dieser Studie sollen die objektiven Auswirkungen untersucht werden, die kognitive Gruppentherapie und Glückstraining bei Patienten mit Major Depression (MD) auf die lokale Hirndurchblutung haben. Patienten, Material, Methoden: Diese Untersuchung hat ein semi-experimentelles Prätest-PosttestDesign mit einer Kontrollgruppe. Drei Gruppen mit gleicher Patientenzahl wurden gebildet: 12 Patienten wurden zufällig ausgewählt. Die erste Gruppe depressiver Patienten profitierte von der Kombination aus Phar- makotherapie und kognitiver Verhaltenstherapie. In der zweiten Gruppe wurde die Phar- makotherapie mit Glückstraining kombiniert. Die dritte Gruppe erhielt nur Pharmakotherapie. Wir verglichen die Wirksamkeit der kognitiven Verhaltenstherapie und des Glückstrainings mit der medikamentösen Monotherapie bei Patienten mit MD. In jeder Gruppe führten wir vor und nach der Studie ein Hirn- durchblutungs-SPECT durch. Ergebnisse: Die Studie wurde an 36 Patienten mit MD durchgeführt (32 Frauen und 4 Männer; mittleres Alter: 41,22 ± 9,08 Jahre; Spanne: 27-65 Jahre). In den beiden experimentellen Gruppen unterschieden sich die beiden Wirksamkeitsparameter vor und nach der Studie signifikant (p < 0,001), während diese Unterschiede in der Kontrollgruppe nicht signifikant waren (p > 0,05). Außerdem gab es in den beiden experimentellen Gruppen vor und nach der Studie signifikante Unterschiede bei der regionalen Hirndurchblutung in frontalen und präfrontalen Bereichen (p < 0,001), in der Kontrollgruppe waren auch diese Unterschiede nicht signifikant (p > 0,05). Schlussfolgerung: Die Studie zeigt bei Patienten mit MD in den frontalen Bereichen eine verminderte zerebrale Durchblutung, die nach einer kognitiven Verhaltenstherapie und einem Glücktraining ansteigt. Aufgrund ihrer Verfügbarkeit, den niedrigen Kosten, der leichten Durchführbarkeit und der sich ergebenden objektiven semi-quantitativen Informationen könnte die Untersuchung mittels Hirndurch- blutungs-SPECT hilfreich bei der Diagnostik und der Therapiekontrolle sein. Weitere Untersuchungen sind notwendig, um die klinische Bedeutung zu validieren.

Keywords

Major depression - cognitive group therapy - happiness training - brain perfusion SPECT

Schlüsselwörter

Major Depression - kognitive Gruppentherapie - Glückstraining - Hirndurchblutungs SPECT

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