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| ???org.dspace.app.webui.jsptag.ItemTag.dcfield??? | Value | Language |
|---|---|---|
| dc.contributor.advisor | 陳祈玲(Chi-Ling Chen) | |
| dc.contributor.author | Nai-Tzu Yao | en |
| dc.contributor.author | 姚乃慈 | zh_TW |
| dc.date.accessioned | 2022-11-24T03:20:00Z | - |
| dc.date.available | 2021-11-03 | |
| dc.date.available | 2022-11-24T03:20:00Z | - |
| dc.date.copyright | 2021-11-03 | |
| dc.date.issued | 2021 | |
| dc.date.submitted | 2021-10-08 | |
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/80874 | - |
| dc.description.abstract | 目的：抗抑鬱劑和認知行為治療均可有效降低憂鬱症和物質使用疾患的症狀。然而，目前針對合併使用這兩項治療的療效研究僅有少數且結果尚無定論。此外，過去之統合分析側重於特定族群，且收納之研究未排除非使用認知行為治療，導致具醫學實證之心理治療的效果被低估。因此，本研究的目的是進行系統性文獻回顧並使用統合分析來探討合併使用抗抑鬱劑及認知行為治療對憂鬱症伴隨物質使用疾患的患者的療效。 研究方法：本研究對隨機對照試驗進行統合分析。針對 2000 年後至 2021 年 3 月之間所發表之研究於PubMed、Embase、PsychINFO 和 Cochrane等資料庫進行系統性審查。最終本研究共收納9 項隨機對照試驗，總共分析 761 名受試者。療效之測量為憂鬱症和物質使用疾患之結果，此外，本研究也進行次族群分析以進一步探討合併治療在不同族群中之療效。 結果：在憂鬱症結果方面，與使用安慰劑加上認知行為治療組相比，合併治療組的治療緩解效果顯著（p=0.02）。針對量表分數百分比的平均變化，合併治療組比安慰劑加上認知行為治療組下降了百分之三（p=0.002），而憂鬱症評分量表分數的平均變化在組間沒有顯著差異（p=0.09）。在物質使用疾患結果方面，組間物質使用的數量或頻率沒有顯著差異（p=0.86，p=0.46）。在次族群分析中，在青少年和成人族群並無發現憂鬱症療效的具顯著性差異。 結論：本研究結果顯示，在認知行為治療中加入抗憂鬱劑並沒有減少物質的使用，然而，此合併治療可能有效改善同時患有憂鬱症和物質使用疾患病人的憂鬱症症狀。此外，次族群分析中納入之隨機對照臨床試驗數量有限因而無法獲得具檢定力之結論，尚待未來進行更多臨床試驗來研究合併治療在這些族群中的療效。 | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-24T03:20:00Z (GMT). No. of bitstreams: 1 U0001-2609202119394300.pdf: 2961695 bytes, checksum: 8e9c68bd65b6d72e815a6d23565029bb (MD5) Previous issue date: 2021 | en |
| dc.description.tableofcontents | "口試委員會審定書 i 致謝 ii 中文摘要 iii Abstract v 目錄 vii 1. Introduction 1 2. Method 5 2.1. Data sources and searches 5 2.2. Selection criteria 5 2.3. Outcome measures 6 2.4. Data extraction and quality assessment 7 2.5. Statistical analysis 7 3. Result 8 3.1. Search findings 8 3.2. Characteristics of included studies 9 3.3. Meta-analysis for depression outcomes 10 3.4. Meta-analysis for substance-use outcomes 16 3.5. Quality assessment and publication bias 18 4. Discussion 19 4.1. Strength and limitation 23 4.2. Conclusion 24 5. Reference 27 Appendix A: PRISMA Checklist 31 Appendix B: Protocol 34 1. PURPOSE OF THE STUDY 51 1.1. Background 51 1.2. Summary of prior clinical studies 53 1.3. Intended use of the treatment 54 1.4. Study Design Rationale 56 1.5. Risk and Benefits 58 1.6. Study Objectives 59 1.6.1. Primary objective 59 1.6.2. Secondary objective 59 1.7. Anticipated duration of the clinical investigation 60 2. CLINICAL PROTOCOL 60 2.1. Protocol Number and Title 60 2.2. Protocol Version Number and Date 60 2.3. Study Design 60 2.3.1. General study design 60 2.3.2. Study design schematic 60 2.4. Subject Selection 62 2.4.1. General characteristics of the proposed subject population 62 2.4.2. Anticipated number of subjects 62 2.4.3. Inclusion criteria 63 2.4.4. Exclusion criteria 64 2.5. Study Procedure 65 2.5.1. Screening phase 65 2.5.2. Double-Blind treatment phase 65 2.5.3. Follow-Up phase 67 2.5.4. Schedule of activities 67 2.5.5. Subject completion 68 2.5.6. Screening failures 69 2.5.7. Withdrawal of subjects 69 2.5.8. Unblinding 70 2.6. Study Treatment 71 2.6.1. Allocation to treatment 71 2.6.2. Study treatment 72 2.6.3. Fluoxetine: Labeling and packaging 73 2.6.4. Fluoxetine: Storage 73 2.6.5. Fluoxetine: Dispensation and administration 74 2.6.6. Accountability and compliance 74 2.6.7. Concomitant and prohibited medications 75 2.7. Description of Protocol Assessment and Procedures 76 2.7.1. Informed consent 76 2.7.2. Eligibility assessment 76 2.7.3. Subject demographics 77 2.7.4. Medical history 77 2.7.5. Vital sign 78 2.7.6. Height, Weight, BMI 78 2.7.7. Physical exam 78 2.7.8. Laboratory assessment 78 2.7.9. EKG 79 2.7.10. Urine Pregnancy Test 79 2.7.11. Hamilton's Depression Rating Scale (HAMD) 79 2.7.12. Clinical Global Impression Scale-Severity (CGI-S) and Clinical Global Impression -Improvement (CGI-I) 82 2.7.13. Substance Use Self-Monitoring Log 85 2.7.14. Columbia-Suicide Severity Rating Scale (C-SSRS) 86 2.8. Statistical Considerations 87 2.8.1. Study endpoints 87 2.8.2. Sample size determination 88 2.8.3. Blinding and prevention of bias 88 2.8.4. General statistical considerations 89 2.8.5. Statistical methods 89 2.8.6. Outcome data and data analysis 90 3. RISK ANALYSIS 91 3.1. Adverse Event Reporting 91 3.1.1. Adverse event definitions 91 3.1.2. Eliciting adverse effect information 93 3.1.3. Recording and assessment of adverse effects 93 3.1.4. Abnormal test findings 93 3.1.5. Causality and severity assessment 94 3.1.6. Reporting adverse effects to the regulatory authorities 95 3.1.7. Reporting adverse effects to the responsible IRB 95 3.2. Withdrawal of Subjects Due to Adverse Effects 95 4. QUALITY ASSURANCE 96 4.1. Monitoring 96 4.2. Data and Safety Monitoring Committee 96 5. DATA MANAGEMENT 97 5.1. Data handling and record-keeping 97 5.2. Record maintenance and retention 98 6. ETHICAL AND DISSEMINATION 99 6.1. Research ethics approval 99 6.2. Protocol amendments 101 6.3. Informed consent 101 6.4. Confidentiality 103 7. REFERENCE 104" | |
| dc.language.iso | en | |
| dc.subject | 系統性文獻回顧 | zh_TW |
| dc.subject | 憂鬱症 | zh_TW |
| dc.subject | 物質使用疾患 | zh_TW |
| dc.subject | 抗憂鬱劑 | zh_TW |
| dc.subject | 認知行為治療 | zh_TW |
| dc.subject | 統合分析 | zh_TW |
| dc.subject | depression | en |
| dc.subject | systematic review | en |
| dc.subject | meta-analysis | en |
| dc.subject | cognitive behavior therapy | en |
| dc.subject | antidepressants | en |
| dc.subject | substance use disorder | en |
| dc.title | 探討抗憂鬱劑合併認知行為治療於憂鬱症伴隨物質使用疾患患者之療效：系統性文獻回顧、統合分析與臨床試驗計畫書 | zh_TW |
| dc.title | "Efficacy of antidepressants in combination with cognitive behavior therapy in the treatment of patients with co-occurring depression and substance use disorder: a systematic review, meta-analysis and clinical trial protocol " | en |
| dc.date.schoolyear | 109-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 張榮珍(Hsin-Tsai Liu),林家齊(Chih-Yang Tseng) | |
| dc.subject.keyword | 憂鬱症,物質使用疾患,抗憂鬱劑,認知行為治療,統合分析,系統性文獻回顧, | zh_TW |
| dc.subject.keyword | depression,substance use disorder,antidepressants,cognitive behavior therapy,meta-analysis,systematic review, | en |
| dc.relation.page | 107 | |
| dc.identifier.doi | 10.6342/NTU202103369 | |
| dc.rights.note | 同意授權(限校園內公開) | |
| dc.date.accepted | 2021-10-09 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
| Appears in Collections: | 臨床醫學研究所 | |
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| U0001-2609202119394300.pdf Access limited in NTU ip range | 2.89 MB | Adobe PDF |
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