Læknablaðið - 15.11.2013, Side 21
RANNSÓKN
að þátttakendum var ekki ljóst að áhrif lyfjameðferðar á árangur
yrðu metin. Því er ólíklegt að lyfjanotkun þeirra hafi litað sjálfs-
mat þeirra á BAI og BDI-II-kvörðunum.
í rannsókninni var lagt upp með að skoða ávinning af HAM
á námskeiðsformi og hvort notkun algengra þunglyndislyfja,
róandi lyfja og algengustu svefnlyfja hefði mögulega neikvæð
áhrif á þann ávinning. Niðurstöðurnar sýna að þátttakendur hafa
marktækan ávinning af meðferðinni og að notkun ofangreindra
lyfja er ekki frábending fyrir HAM-hópmeðferð í heilsugæslunni
hér á landi, enda reyndist árangur þunglyndismeðferðar raunar
mestur hjá þeim sem einnig taka þunglyndislyf.
Þakkir
Höfundar þakka Ástu Jónasdóttur, Margréti Ólafíu Tómasdóttur
og Maríu Hrönn Nikulásdóttur hjálp við gagnasöfnun og rit-
rýnum fyrir margar góðar ábendingar. Einnig viljum við þakka
Baldri Heiðari Sigurðssyni aðstoð við tölfræðiúrvinnslu. Að lok-
um þökkum við sálfræðingum á geðsviði, starfsfólki heilsugæsl-
unnar og þeim fjölmörgu sjúklingum sem komu að rannsókninni
með einum eða öðrum hætti fyrir þeirra mikilvæga framlag og
gott samstarf.
Heimildir
1. Sigurösson E, Ólafsdóttir Þ, Gottfreðsson M. Public views
on antidepressant treatment: lessons from a national
survey. Nord J Psychiatry 2008; 62:374-8.
2. Cuijpers P, van Straten A, van Oppen P, Andersson G. Are
psychological and pharmacologic interventions equally
effective in the treatment of adult depressive disorders?
A meta-analysis of comparative studies. J Clin Psychiatry
2008; 69:1675-85.
3. Sighvatsson MB, Kristjansdottir H, Sigurdsson E,
Sigurdsson JF. Gagnsemi hugrænnar atferlismeðferðar við
lyndis- og kvíðaröskunum hjá fullorðnum. Læknablaðið
2011; 97:613-9.
4. Thase ME, Friedman ES. Is psychotherapy an effective
treatment for melancholia and other severe depressive
states? J Affect Disord 1999; 54:1-19.
5. National Institute for Health and Care Excellence 2009.
The treatment and management of depression in adults.
CG90. National Institute for Health and Care Excellence,
London.
6. DeRubeis RJ, Hollon SD, Amsterdam JD, Shelton RC,
Young PR, Salomon RM, et al. Cognitive therapy vs
medications in the treatment of moderate to severe
depression. Arch Gen Psychiatry 2005; 62:409-16.
7. Black D. Efficacy of Combined Pharmacotherapy and
Psychotherapy versus Monotherapy in the Treatment of
Anxiety Disorders. CNS Spectr 2006; 11:10: 29-33.
8. Cujipers P, Dekker J, Hollon SD, Andersson G. Adding
psychotherapy to pharmacotherapy in the Treatment of
Depressive Disorders in adults: A Meta-Analysis. J Clin
Psychiatry 2009; 70:1219-29.
9. Pampallona S, Bollini P, Tlbaldi G, Kupelnick B, Munizza
C. Combined pharmacotherapy and psycosocial treatment
for depression: a systematic review. Arch Gen Psychiatry
2004; 61: 714-9.
10. Marks IM, Swinson RP, Basoglu M, Kuch K, Noshirvani
H, O'Sullivan G, et al. Alprazolam and exposure alone
and combined in panic disorder with agoraphobia. A
controlled study in London and Toronto. Br J Psychiatry
1993; 162: 776-87.
11. Westra HA, Stewart SH: CBT and pharmacotherapy:
complimentary or contradictory approaches ot the treat-
ment of anxiety? J Clin Psychiatry 1998; 18: 307-40.
12. Power KG, Simpson RJ, Swanson V, Wallace LA.
Controlled comparison of pharmacological and psycho-
logical treatment of generalized anxiety disorder in
primary care. Br J Gen Pract 1990; 40:289-94.
13. Bandelow B, Seidler-Brandler U, Becker A, Wedekind D,
Riither E. Meta-analysis of randomized controlled comp>-
arisons of psychopharmacological and psychological
treatments for anxiety disorders. Wörld J Biol Psychiatry
2007; 8:175-87.
14. Watanabe N, Churchill R, Furukawa TA. Combination of
psychotherapy and benzodiazepines versus either therapy
alone for panic disorder: a systematic review. BMC
Psychiatry 2007; 5:18.
15. National Institute for Health and Care Excellence 2011.
Generalised anxiety disorder and panic disorder (with or
without agoraphobia) in adults. CG113. National Institute
for Health and Care Excellence, London.
16. Furukawa TA, Churchill R, Watanabe N. Combined
psychotherapy plus antidepressants for panic disorder
with or without agoraphobia (Review). Cochr Datab Syst
Rev 2007; 4:467-8601.
17. Hetrick SE, Purcell R, Gamer B, Parslow R. Combined
pharmacotherapy and psychological therapies for post
traumatic stress disorder (PTSD). Cochr Datab Syst Rev
2010; 6: 7.
18. van Apeldoom FJ, Timmerman ME, Mersch PP, van
Hout WJ, Visser S, et al. A randomized trial of cognitive-
behavioral therapy or selective serotonin reuptake inhibi-
tor or both combined for panic disorder with or without
agoraphobia: treatment results through 1-year follow-up. J
Clin Psychiatry 2010; 71:574-86.
19. Hans E, Hillier W. Effectiveness of and dropout from
outpatient cognitive behavioral therapy for adult unipolar
depression: a meta-analysis of nonrandomized effective-
ness studies. J Consult Clin Psychol 2013; 81: 75-88.
20. Blanco C, Heimberg RG, Schneier FR, Fresco DM, Chen
H, Turk CL, et al. A placebo-controlled trial of phenelz-
ine, cognitive behavioral group therapy, and their comb-
ination for socialanxiety disorder. Arch Gen Psyciatry
2010; 67:286-95.
21. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs
J, Weiller, et al. The Mini-Intemational Neuropsychiatric
Interview (M.I.N.I.): the development and validation of
a structured diagnostic psychiatric interview for DSM-IV
and ICD-10. J Clin Psychiatry 1998; 59 Suppl 20: 22-33;
quiz 34-57.
22. Sigurdsson, BH. Comparison between two standardised
psychiatric interviews and two self-report measures:
MINI, CIDI, PHQ and DASS (Cand Psych). University of
Iceland, Reykjavík 2008.
23. Beck AT, Steer RA, Brown GK. BDI-II, Beck Depression
Inventory II: Manual (2nd ed.). The Psychological
Corporation, Harcourt, Brace, and Company, Boston 1996.
24. Amarson TO, Olason DT, Smari J, Sigurdsson JF. The
Beck Depression Inventory Second Edition (BDI-II):
psychometric properties in Icelandic student and patient
populations. Nord J Psychiatry 2008; 62:360-5.
25. Beck AT, Epstein N, Brown G, Steer RA. An inventory
for measuring dinical anxiety. Psychometric properties. J
Consult Clin Psychol 1988; 56:893-7.
26. Sæmundsson BR, Thorsdottir F, Kristjansdottir H, Olason
DÞ, Smari J, Sigurdsson JF. Psychometric properties of
the Icelandic version of the Beck Anxiety Inventory in a
clinical and a student population. Eur J Psychol Assess
2011;27:133-41.
27. Helgason T, Tomasson H, Zoega T. Antidepressants and
public health in Iceland. Time series analysis of national
data. Br J Psychiatry 2004; 184:157-62.
28. sjukra.is/lyf-og-hjalpartaeki/lyf/skyrslur-um-lyfjakost-
nad/ -maí2013
LÆKNAblaðiö 2013/99 509