اثربخشی شناخت درمانی مبتنی بر ذهن آگاهی بر افسردگی، کیفیت زندگی و میزان کورتیزول سرم در افراد افسرده
الموضوعات : فصلنامه زیست شناسی جانوری
زهرا علیایی
1
(گروه روان شناسی بالینی، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران.)
مسعود محمدی
2
(گروه روان شناسی بالینی، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران.)
کاظم انوری
3
(مرکز تحقیقات سرطان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.)
سید ابراهیم حسینی
4
(گروه آموزشی فیزیولوژی، واحد شیراز، دانشکده علوم، موسسه آموزش عالی زند شیراز، شیراز، ایران)
الکلمات المفتاحية: کیفیت زندگی, کورتیزول, شناخت درمانی مبتنی بر ذهن آگاهی, افراد افسرده,
ملخص المقالة :
افسردگی در حال حاضر یک بیماری مزمن شایع در اغلب جوامع سراسر جهان است که می‌تواند عملکرد نرمال را مختل کند، افکار افسردگی ایجاد کرده و بر کیفیت زندگی تاثیر منفی بگذارد. هدف از پژوهش حاضر، بررسی اثربخشی شناخت درمانی مبتنی بر ذهن‌آگاهی بر کیفیت زندگی، افسردگی و میزان کورتیزول در افراد مبتلا به افسردگی است.۳۰ زن مبتلا به افسردگی به طور داوطلبانه انتخاب و به صورت تصادفی به دو گروه تجربی(15نفر) و کنترل (15نفر) تقسیم شدند. برای آزمودنی های گروه تجربی جلسات درمانی به مدت هشت جلسه 90 دقیقه ای در هفته برگزار گردید و گروه گواه هیچ درمانی دریافت نکردند. برای اندازه گیری متغیرها از پرسش نامه های افسردگی بک ((BDI-II و کیفیت زندگی SF36 در دو نوبت (قبل و بعد درمان) استفاده شد و به منظور بررسی اندازه گیری سطح کورتیزول، نمونه گیری خون بین ساعت 8 الی 10صبح قبل از شروع اولین و بعد از آخرین جلسه درمان به عمل آمد. برای تحلیل داده ها از آزمون آماری تحلیل کواریانس استفاده شد. نتایج نشان داد که شناخت درمانی مبتنی بر ذهن آگاهی در مرحله پیش آزمون- پس آزمون باعث کاهش افسردگی و کورتیزول به ترتیب از میزان 87/23 و 48/14 به 13/10 و 95/11 و افزایش کیفیت زندگی از میزان 90/32 به 52/83 در گروه آزمایش شد (001/0 > p). بر اساس یافته های تحقیق حاضر می توان چنین نتیجه گیری کرد که شناخت درمانی مبتنی بر ذهن اگاهی می تواند وضعیت روانی و کیفیت زندگی بیماران مبتلا به افسردگی را بهبود بخشد.
1- Alenko A., Markos Y., Fikru C., Tadesse E., Gedefaw L., 2020. Association of serum cortisol level with severity of depression and improvement in newly diagnosed patients with major depressive disorder in Jimma medical center, Southwest Ethiopia. PLoS ONE, 15(10): e0240668.
2- Aguilar R., Jiménez M., Alvero-Cruz J. R., 2013. Testosterone, cortisol and anxiety in elite field hockey players. Physiology and Behavior, 119: 38-42.
3- Beddig T., Timm C., Ubl-Rachota B., Zamoscik V., Ebner-Priemer U., Reinhard I., Kirsch P., Kuehner C., 2020. Mindfulness-based focused attention training versus progressive muscle relaxation in remitted depressed patients: Effects on salivary cortisol and associations with subjective improvements in daily life. Psychoneuroendocrinology, 113:104555.
4- Baxter A. J., Scott K. M., Ferrari A. J., Norman R. E., Vos T., Whiteford H. A., 2014. Challenging the myth of an “epidemic” of common mental disorders: Trends in the global prevalence of anxiety and depression between 1990 and 2010. Depression and Anxiety, 31: 506–516.
5- Beserra A.H.N., Kameda P., Deslandes AC., Schuch FB., Laks J., Moraes H.S., 2018. Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis. Trends Psychiatry Psychother, 40(4): 360-368.
6- Bielczyk N. Z., Buitelaar J. K., Glennon J. C., Tiesinga P. H., 2015. Circuit to construct mapping: a mathematical tool for assisting the diagnosis and treatment in major depressive disorder. Front Psychiatry, 6: 29.
7- Bishop S. R., Lau M., Shapiro S., Carlson L., Anderson N. D., Carmody J., Devins G., 2006. Mindfulness: A Proposed Operational Definition. Clinical Psychology: Science and Practice, 11(3): 230–241.
8- Burke H.M., Davis M.C., Otte C., Mohr D.C., 2005. Depression and cortisol responses to psychological stress: a meta-analysis. Psychoneuroendocrinology, 30: 846–856.
9- Cladder-Micus M. B., Speckens A. E. M., Vrijsen J. N., Donders A. R. T., Becker E. S., Spijker J., 2018. Mindfulness-based cognitive therapy for patients with chronic, treatment-resistant depression: A pragmatic randomized controlled trial. Depression and Anxiety, 35(10): 914–924.
10- Cho Y., Lee J.K., Kim D.H., Park J.H., Choi M., Kim H.J., 2019. Factors associated with quality of life in patients with depression: A nationwide populationbased study. PloS one, 14(7): e0219455.
11- Cipriani A., Purgato M., Furukawa T. A., Trespidi C., Imperadore G., Signoretti A., Churchill R., Watanable N., Barbui C., 2012. Citalopram versus other anti‐depressive agents for depression. Cochrane Database of Systematic Reviews, 7(7):CD006534.
12- Cui R., 2015. Editorial: a systematic review of depression. Current Neuropharmacol, 13(4): 480.
13- Dolle K., Schulte-Körne G., O'Leary A. M., von Hofacker N., Izat Y., Allgaier A. K., 2012. The Beck Depression Inventory-II in adolescent mental health patients: Cut-off scores for detecting depression and rating severity. Psychiatry Research, 200(2-3): 843-848.
14- Farb N., Anderson A., Ravindran A., Hawley L., Irving J., Mancuso E., Gulamani T., Williams G., Ferguson A., Segal Z. V., 2018. Prevention of relapse/recurrence in major depressive disorder with either mindfulness-based cognitive therapy or cognitive therapy. Journal of Consulting and Clinical Psychology, 86(2): 200.
15- Ferreira M., Ferreira S., Ferreira N., Andrade J., Chaves C., Duarte, J., 2016. Lifestyles and Surveillance of Sexual and Reproductive Women's Health. Procedia-Social and Behavioral Sciences, 217: 1019-1027.
16- Fox K.C., Nijeboer S., Dixon M.L., Floman J.L., Ellamil M., Rumak S.P., 2014. Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neuroscience and Biobehavioral Reviews, 43: 48-73.
17- Ghassemzadeh, H., Mojtabai, R., Karamghadiri, N., & Ebrahimkhani, N., 2005. Psychometric properties of a Persian language version of the Beck Depression Inventory Second edition: BDI‐II‐PERSIAN. Depression and Anxiety, 21(4): 185-192. [in Persian].
18- Gholamrezaei H., Hosseinzadeh Moghadam N., Boostan S., 2020. The effectiveness of mindfulness-based cognitive therapy in reducing depression in cancer patients. JNIP, 4(8): 1-8. [in Persian].
19- Goldberg S. B., Tucker R. P., Greene P. A., Davidson R. J., Wampold B. E., Kearney D. J., Simpson T.L., 2018. Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical Psychology Review, 59: 52–60.
20- Gotink R.A., Chu P., Busschbach J.J., Benson H., Fricchione, G.L., Hunink M.G., 2015. Standardised mindfulness- based interventions in healthcare: an overview of systematic reviews and meta-analyses of RCTs. PloS one, 10(4): e0124344.
21-Goyal M., Singh S., Sibinga E. M., Gould N. F., Rowland-Seymour A., Sharma, R., Berger Z., Sleicher D., Maron D. D., Shihab H. M., Ranasinghe P.D., Linn S., Sah S., Bass E.B., Haythornthwaite J.A., 2014. Meditation programs for psychological stress and well-being. JAMA Internal Medicine, 174: 357–368.
22- Hedman-Lagerlof M., Hedman-Lagerlof E., Ost L. G., 2018. The empirical support for mindfulness-based interventions for common psychiatric disorders: A systematic review and meta-analysis. Psychological Medicine, 48(13): 2116–2129.
23-Hinkelmann K., Moritz S., Botzenhardt J., Muhtz C., Wiedemann K., 2012. Changes in cortisol secretion during antidepressive treatment and cognitive improvement in patients with major depression: a longitudinal study. Psychoneuroendocrinology, 37: 685-692.
24- Islam MR., Ahmed I., Moktadir A.A., Nahar Z., 2018. Elevated serum levels of malondialdehyde and cortisol are associated with major depressive disorder: A case-control study. SAGE open medicine 6: 2050312118773953.
25- Koncz A., Demetrovics Z., Zsofia K., 2020. Meditation interventions efficiently reduce cortisol levels of at-risk samples: a meta-analysis, Health Psychology Review. 15(1): 56-84.
26- Khodabakhsh P. R., Taghavi K. S., Rastgoo F., 2019. Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Neurofeedback Techniques on Women's Depression Adult. Clinical Psychology Studies, 9(36): 25-46. [in Persian].
27- Kuyken W., Hayes R., Barrett B., Byng R., Dalgleish T., Kessler D., Cardy, J., 2015. Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. The Lancet, 386(9988): 63-73
28-Lenz A. S., Hall J., Smith L. B., 2016. Meta-analysis of group mindfulness-based cognitive therapy for decreasing symptoms of acute depression. Journal for Specialists in Group Work, 41(1): 44–70.
29- Lopez-Duran N.L., Kovacs M., George C.J., 2009. Hypothalamic–pituitary–adrenal axis dysregulation in depressed children and adolescents: A meta-analysis. Psychoneuroendocrinology, 34: 1272–1283.
30- Lucassen P.J., Pruessner J., Sousa N., Almeida O.F., Van Dam A.M., 2014. Neuropathology of stress. Acta Neuropathologica, 127: 109–135.
31- Luo Y., Zhang S., Zheng R., Xu L., Wu J., 2018. Effects of depression on heart rate variability in elderly patients with stable coronary artery disease. Journal of Evidence Based Medicine, 11(4): 242-245.
32- Matheson K., Jorden S., Anisman H., 2008. Relations between trauma experiences and psychological, physical and neuroendocrine functioning among Somali refugees: Mediating role of coping with acculturation stressors. Journal of Immigrant and Minority Health, 10: 291–304.
33- Moica T., Gabos Grecu I., Buicu G.E., Ferencz M., Grecu M., Salcudean A., Popa C.O., 2016. Increased cortisol levels in depression: A comparative study evaluating the correlation of hypercortisolemia with prosocial coping mechanisms. Acta Medica Marisiensis, 62: 68–72.
34- Montazeri A., Gashtasbi A., Vahidaninia M., 2005. Translation Determination of Reliability and Validity of the Persian Species of the SF-36 uestionnaire. Payesh Journal, 5(1): 4956. [in Persian].
35- Mohammadpour S., Tajikzadeh F., Mohammadi N., 2018. The effectiveness of mindfulness-based cognitive therapy on reducing depressive symptoms, rumination and dysfunctional attitudes of pregnant women with depression. Clinical Psychology and Personality (Behavior Scholar), 16(1): 187-198. [in Persian].
36- Musa A., Zulkiflu S., Kim Lam F., Mukhtar S., Kwong Yan O., Tajudeen Olalekan S., Kim Geok S., 2020. Effectiveness of mindfulness-based cognitive therapy among depressed individuals with disabilities in Nigeria: A randomized controlled trial. Psychiatry Research, 296: 113680.
37- Nasiri Kalmarzi R., Moradi G., Asmaei Majd S., Khanpour F., 2018. The effectiveness of mindfulness-based cognitive therapy on quality of life and mindfulness of patients with asthma. Cognitive Psychology and Psychiatry, 5(5): 1-14. [in Persian].
38- Parsons C. E., Crane C., Parsons L. J., Fjorback L. O., Kuyken W., 2017. Home practice in mindfulness-based cognitive therapy and mindfulness-based stress reduction: a systematic review and meta-analysis of participants' mindfulness practice and its association with outcomes. Behaviour Research and Therapy, 95: 29-41.
39- Pasha R., Sarraj khorami A., 2018. The effects of mindfulness based cognitive therapy on thinking rumination and dysfunctional attitudes in patients suffering from major depression disorder (MDD) and obsessive-compulsive disorder (OCD). Journal of Psychological Achievements, 25(1): 93-112. [in Persian].
40- Pascoe M. C., Thompson D. R., Jenkins Z. M., Ski C. F., 2017. Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. Journal of Psychiatric Research, 95:156-178.
41- Rahimian Booger A., Younesi J., 2014. John D. Teesdale: Metacognition, mindfulness and the modification of mood disorders, Published by Danje. [in Persian].
42- Rafie M., Sabahi P., Shahrokh Makvand Hosseini Sh., 2020. The effectiveness of mindfulness-based cognitive therapy on depression, anxiety, stress and quality of life of elderly men living in nursing homes. Journal of Mashhad University of Medical Sciences, 62: 870-879. [in Persian].
43- Sanada, K., Montero-Marin, J., Alda Díez, M., Salas-Valero, M., Pérez-Yus, M. C., Morillo, H., Demarzo, M. M. P., García-Toro, M., García-Campayo, J. (2016). Effects of mindfulness-based interventions on salivary cortisol in healthy adults: A meta-analytical review. Frontiers in Physiology, 7: 471.
44- Shallcross A., Willroth E., Fisher A., Dimidjian S., Gross J., Visvanathan P., Mauss I. 2018. Relapse/recurrence prevention in major depressive disorder: 26-month follow-up of mindfulness-based cognitive therapy versus an active control. Behaviour Therapy, 49(5): 836–849.
45- Strauss C., Cavanagh K., Oliver A., Pettman D., 2014. Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials. PLOS One, 9(4): e96110.
46- Tomasino B., Fregona S., Skrap M., Fabbro F., 2013. Meditation-related activations are modulated by the practices needed to obtain it and by the expertise: an ALE meta-analysis study. Frontiers in Human Neuroscience, 6: 346.
47-Wang Y. Y., Li X. H., Zheng W., Xu Z. Y., Ng C. H., Ungvari G. S., Xiang Y. T., 2018. Mindfulness-based interventions for major depressive disorder: A comprehensive meta-analysis of randomized controlled trials. Journal of Affective Disorders, 229: 429-436.
48- Zhao Y., Zhang Q., Shao X., Ouyang L., Wang X., Zhu K., Chen L., 2017. Decreased glycogen content might contribute to chronic stress-induced atrophy of hippocampal astrocyte volume and depression-like behavior in rats. Scientific Reports, 7(1): 1-14.
_||_