In response to calls for much needed research on the relation between gender role conflict and therapy or counselling this study examined the relation between gender role conflict and the types of therapy that men prefer for the treatment of depression, comparing men scoring high and low on the gender role conflict scale. The study also examined whether exposure of men reporting high or low gender role conflict to either emotion-focused or thought-focused therapy through the use of a counselling video influences subsequent preference for type of therapy, and the role of coping as a mediator in the relationship between gender role conflict and therapy preference. Furthermore, the study examined traditional men’s perspectives on therapy focussing in particular on issues inherent in living with the experience of depression: coping with depression, seeking help for depression, and the barriers to seeking help. The central aim of the thesis was to examine how to make psychological services more appealing to men who have experienced depression. Overall the current research revealed insights into men’s experience of depression, their therapy preferences, their coping strategies, the physical and psychosocial barriers that deter them from seeking help, and many practical suggestions for possible interventions to help men cross the barriers and open up. It is concluded that understanding the traditional men, their socialisation and its impact on depression, on the man’s help-seeking behaviour and attitudes, is certainly needed to assist in meeting the needs of men and to influence the transformation of traditional men. / Doctor of Philosophy (PhD)

Leung Yeuk Sin Eugenie. / "July 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 220-237). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Regulatorische T-Zellen (Tregs, CD4+CD25hi-Tregs) haben u. a. die Aufgabe, die Immunantwort sowie die Zytokinfreisetzung zu steuern, um die Immuntoleranz gegenüber körpereigenen Antigenen aufrecht zu erhalten. Es wurde beschrieben, dass depressive Patienten eine erniedrigte Konzentration von Tregs aufweisen. Da es Hinweise darauf gibt, dass Zytokine wie Interleukin (IL)-1IL-6 und Interferon (IFN)-eine Rolle in der Pathophysiologie der Depression spielen, und dass sich die Konzentrationen dieser Zytokine während antidepressiver Therapie ändern, untersuchten wir Veränderungen der Produktion von IL-1IL-6 und IFN- und Veränderungen der Konzentration von CD4+CD25hi-Tregs während antidepressiver Therapie. Wir gewannen dazu das Blut von 16 Patienten mit depressiver Störung in der ersten und sechsten Woche nach stationärer Aufnahme, indem wir die Plasmakonzentrationen von IL-1bestimmten. Ferner wurde die Produktion von IL-1, IL-6 und IFN-in einem Vollblut-Assay unter immunologischer Stimulation mit Lipopolysaccharid (LPS) oder Newcastle Disease Virus (NDV) in-vitro gemessen. Die Lymphozyten wurden differenziert und CD4+CD25hi-Tregs mittels Durchflusszytometrie bestimmt. Der psychopathologische Status wurde mit der Hamilton-Depressionsskala (HAMD-21) erfasst. Der HAMD-21-Score, die IL-1-Plasmakonzentrationen sowie die LPS-induzierte IL1-- und IL-6-Produktion waren nach sechs Wochen antidepressiver Behandlung signifikant gegenüber der Baseline erniedrigt. Dagegen stieg der Anteil der CD4+CD25hi-Tregs unter den Lymphozyten von 2,74% ± 0,88 (Mittelwert ± Standardabweichung) auf 3,54% ± 1,21 signifikant (p = 0,007) an. Es fand sich keine signifikante Änderung der NDV-induzierten IFN--Produktion. Der Anstieg der CD4+CD25hi-Tregs während antidepressiver Therapie könnte mit dem Abfall der Zytokinproduktion und der psychopathologischen Verbesserung der Patienten in einem kausalen Zusammenhang stehen.

A Eletroconvulsoterapia (ECT) é o tratamento biológico mais eficaz para quadros depressivos. Os estudos de seus aspectos técnicos são fundamentais tanto para compreensão dos mecanismos da ECT quanto para maximizar a eficácia e minimizar seus efeitos cognitivos. Existem muitos métodos para o cálculo da dose do estímulo elétrico e não há consenso em relação ao melhor. Sabe-se que doses muito elevadas tendem a ser eficazes, mas à custa de efeitos na memória. Embora o método de titulação seja recomendado pela Associação Psiquiátrica Americana, muitos profissionais tem preocupação sobre a segurança cardiovascular deste procedimento, devido aos sucessivos estímulos frustros que levam a um aumento na incidência de bradicardia e/ou assistolia. O objetivo deste trabalho foi traçar o perfil dos pacientes submetidos ao método da titulação do limiar, verificando sua segurança cardiovascular. Para isso foi feito um estudo retrospectivo e 113 casos foram revistos no ano de 2007. A maioria (70,3%) recebeu aplicação bilateral e (62,8%) eram mulheres. O diagnóstico de depressão apareceu com mais freqüência (50,5%). A maioria (57,5%) necessitou de dois estímulos, (12,4%) necessitou de apenas um, (28,3%) necessitou de três e (1,8%) realizou quatro estímulos. A média de frequência cardíaca inicial foi de 79,6 bpm (DP = 17). O limiar convulsígeno variou de 16mC a 128mC (média = 58,9; DP 25,4). A relação do limiar convulsígeno foi significativamente menor com o posicionamento unilateral dos eletrodos (p < 0,001), mas não com sexo ou idade. Não foi encontrada associação com a medicação concomitante. A incidência de bradicardia aumentou com os estímulos frustros, mas não foi significante a relação entre o primeiro e segundo estímulos. Não houve complicações cardíacas significativas e nenhum paciente apresentou assistolia. Conclui-se que o método da titulação do limiar pode ser uma estratégia segura e mais precisa, uma vez que os fatores (sexo, idade e uso de medicamentos) não foram relacionados com o LCT; a baixa incidência de complicações cardiovasculares reforça-o como método de escolha. Não se pode descartar um efeito protetor do uso da atropina. / Electroconvulsive therapy (ECT) is the most effective biological treatment for depression. Studies of the technical aspects are fundamental for understanding the mechanisms of ECT and to maximize efficiency and minimize their cognitive effects. There are many methods to determine the dose of electrical stimulation and there is no consensus on which is the best one. It is known that very high doses are effective, but at the expense of effects on memory. Although the method of limits (titration method) is generally accepted, being encouraged by the American Psychiatric Association, many practitioners have concerns regarding cardiac safety of this method. Due to repetitive subthreshold stimuli until the seizure is elicited, an increased risk of bradiarrhythmia and/or asystole is believed to be present. The objective of this study was to establish the profile of patients undergoing the method of titration of the threshold, checking their cardiovascular safety. A retrospective study was performed including 113 cases that receive their treatment in the year of 2007. The majority (70.3%%) received bilateral ECT, (62.8%) were women. The diagnosis of depression appeared more frequently (50.5%). The majority (57.5%) needed two stimuli; 12.4% needed only one; 28.3% needed three and 1.8% required four stimuli. The average initial heart rate was 79.6 bpm (SD = 17). The seizure threshold ranged from 16mC to 128mC (mean = 58.9, SD 25.4). The ratio seizure threshold was significantly lower with unilateral electrode placement (p <0.001) but not with sex or age. No association was found with concomitant medication. There was an increased incidence of bradycardia with subthreshold stimuli , but there was not a relationship between the first and second stimuli. There were no significant cardiac complications and no patient had asystole. In conclusion, the method of titration of the threshold seems to be a safe and more precise to determined electrical dose, since the factors usually used to predict the threshold (gender, age and medication use) were not related to the LCT The low incidence of cardiovascular complications adds up to its use as the method of choice.. A protective effect of atropine cannot be ruled out.

Objetivo: Este estudo teve como intuito investigar a experiência de pacientes adolescentes com depressão refratária a tratamentos farmacológicos a respeito de sua condição, após um tratamento complementar de arte-terapia. Método: A partir de uma entrevista semi-estruturada, o próprio paciente deu seu depoimento sobre como era ter depressão, como vivenciava sua experiência com a doença e como se sentia após o tratamento com arteterapia. Foi realizada uma análise de corte qualitativo usando-se como instrumento de análise o Discurso do Sujeito Coletivo. Resultados: Pacientes extremamente difíceis do ponto de vista clínico apresentaram melhora significativa de relacionamento com o mundo. Puderam constatar por si próprios melhora no auto-conhecimento, reforço na sua identidade e aumento de auto-estima. Verificou-se essa mudança também em suas produções plásticas. A introdução desse tipo de abordagem proporcionou humanização da relação com o paciente em tratamento Conclusão: Proporcionando e promovendo a escuta da voz do universo imaginário dos pacientes, e usando-a como referência, constatou-se melhora significativa de sintomas depressivos através de arte-terapia associada ao tratamento farmacológico / Objective: The author\'s goal was to investigate the experience of the adolescent patient with pharmacological treatment-refractory, unipolar, nonpsychotic, major depression, regarding the patient\'s condition after pharmacological treatment combined with art therapy. Method: Through means of a semi-structured interview, the patient articulated how it was to suffer from major depression, how he/she experienced the disease, and about his/her feelings after the art therapy treatment. The analysis was qualitative, and the analysis instrument used was the Collective Subject Discourse. Results: Extremely difficult patients from a clinical perspective showed significant improvement in both subjective and objective relations with the world. They could verify by themselves insight improvement, and identity expansion and self-esteem increase, what was also noticed in their artwork. This kind of approach facilitated humanization to the patient in treatment. Conclusion: Listening to the voice of the imaginary universe of the patient was facilitated through art therapy. It was possible to distinguish remission of depressive symptoms after the association of art therapy to pharmacological treatment

A Eletroconvulsoterapia (ECT) é o tratamento biológico mais eficaz para quadros depressivos. Os estudos de seus aspectos técnicos são fundamentais tanto para compreensão dos mecanismos da ECT quanto para maximizar a eficácia e minimizar seus efeitos cognitivos. Existem muitos métodos para o cálculo da dose do estímulo elétrico e não há consenso em relação ao melhor. Sabe-se que doses muito elevadas tendem a ser eficazes, mas à custa de efeitos na memória. Embora o método de titulação seja recomendado pela Associação Psiquiátrica Americana, muitos profissionais tem preocupação sobre a segurança cardiovascular deste procedimento, devido aos sucessivos estímulos frustros que levam a um aumento na incidência de bradicardia e/ou assistolia. O objetivo deste trabalho foi traçar o perfil dos pacientes submetidos ao método da titulação do limiar, verificando sua segurança cardiovascular. Para isso foi feito um estudo retrospectivo e 113 casos foram revistos no ano de 2007. A maioria (70,3%) recebeu aplicação bilateral e (62,8%) eram mulheres. O diagnóstico de depressão apareceu com mais freqüência (50,5%). A maioria (57,5%) necessitou de dois estímulos, (12,4%) necessitou de apenas um, (28,3%) necessitou de três e (1,8%) realizou quatro estímulos. A média de frequência cardíaca inicial foi de 79,6 bpm (DP = 17). O limiar convulsígeno variou de 16mC a 128mC (média = 58,9; DP 25,4). A relação do limiar convulsígeno foi significativamente menor com o posicionamento unilateral dos eletrodos (p < 0,001), mas não com sexo ou idade. Não foi encontrada associação com a medicação concomitante. A incidência de bradicardia aumentou com os estímulos frustros, mas não foi significante a relação entre o primeiro e segundo estímulos. Não houve complicações cardíacas significativas e nenhum paciente apresentou assistolia. Conclui-se que o método da titulação do limiar pode ser uma estratégia segura e mais precisa, uma vez que os fatores (sexo, idade e uso de medicamentos) não foram relacionados com o LCT; a baixa incidência de complicações cardiovasculares reforça-o como método de escolha. Não se pode descartar um efeito protetor do uso da atropina. / Electroconvulsive therapy (ECT) is the most effective biological treatment for depression. Studies of the technical aspects are fundamental for understanding the mechanisms of ECT and to maximize efficiency and minimize their cognitive effects. There are many methods to determine the dose of electrical stimulation and there is no consensus on which is the best one. It is known that very high doses are effective, but at the expense of effects on memory. Although the method of limits (titration method) is generally accepted, being encouraged by the American Psychiatric Association, many practitioners have concerns regarding cardiac safety of this method. Due to repetitive subthreshold stimuli until the seizure is elicited, an increased risk of bradiarrhythmia and/or asystole is believed to be present. The objective of this study was to establish the profile of patients undergoing the method of titration of the threshold, checking their cardiovascular safety. A retrospective study was performed including 113 cases that receive their treatment in the year of 2007. The majority (70.3%%) received bilateral ECT, (62.8%) were women. The diagnosis of depression appeared more frequently (50.5%). The majority (57.5%) needed two stimuli; 12.4% needed only one; 28.3% needed three and 1.8% required four stimuli. The average initial heart rate was 79.6 bpm (SD = 17). The seizure threshold ranged from 16mC to 128mC (mean = 58.9, SD 25.4). The ratio seizure threshold was significantly lower with unilateral electrode placement (p <0.001) but not with sex or age. No association was found with concomitant medication. There was an increased incidence of bradycardia with subthreshold stimuli , but there was not a relationship between the first and second stimuli. There were no significant cardiac complications and no patient had asystole. In conclusion, the method of titration of the threshold seems to be a safe and more precise to determined electrical dose, since the factors usually used to predict the threshold (gender, age and medication use) were not related to the LCT The low incidence of cardiovascular complications adds up to its use as the method of choice.. A protective effect of atropine cannot be ruled out.

Objetivo: Este estudo teve como intuito investigar a experiência de pacientes adolescentes com depressão refratária a tratamentos farmacológicos a respeito de sua condição, após um tratamento complementar de arte-terapia. Método: A partir de uma entrevista semi-estruturada, o próprio paciente deu seu depoimento sobre como era ter depressão, como vivenciava sua experiência com a doença e como se sentia após o tratamento com arteterapia. Foi realizada uma análise de corte qualitativo usando-se como instrumento de análise o Discurso do Sujeito Coletivo. Resultados: Pacientes extremamente difíceis do ponto de vista clínico apresentaram melhora significativa de relacionamento com o mundo. Puderam constatar por si próprios melhora no auto-conhecimento, reforço na sua identidade e aumento de auto-estima. Verificou-se essa mudança também em suas produções plásticas. A introdução desse tipo de abordagem proporcionou humanização da relação com o paciente em tratamento Conclusão: Proporcionando e promovendo a escuta da voz do universo imaginário dos pacientes, e usando-a como referência, constatou-se melhora significativa de sintomas depressivos através de arte-terapia associada ao tratamento farmacológico / Objective: The author\'s goal was to investigate the experience of the adolescent patient with pharmacological treatment-refractory, unipolar, nonpsychotic, major depression, regarding the patient\'s condition after pharmacological treatment combined with art therapy. Method: Through means of a semi-structured interview, the patient articulated how it was to suffer from major depression, how he/she experienced the disease, and about his/her feelings after the art therapy treatment. The analysis was qualitative, and the analysis instrument used was the Collective Subject Discourse. Results: Extremely difficult patients from a clinical perspective showed significant improvement in both subjective and objective relations with the world. They could verify by themselves insight improvement, and identity expansion and self-esteem increase, what was also noticed in their artwork. This kind of approach facilitated humanization to the patient in treatment. Conclusion: Listening to the voice of the imaginary universe of the patient was facilitated through art therapy. It was possible to distinguish remission of depressive symptoms after the association of art therapy to pharmacological treatment

O circuito neuronal relacionado à depressão na doença de Parkinson (DP), assim como os efeitos da terapia antidepressiva nestes pacientes, não é bem estabelecido. Os métodos de neuroimagem podem levar ao melhor conhecimento da patogênese e também dos mecanismos de ação relacionados a um tipo específico de tratamento. Para avaliar as diferenças da atividade neuronal, comparamos 21 pacientes com DP e diagnóstico de depressão e 16 sem depressão através de ressonância magnética funcional (RMf) em uma tarefa cognitiva que inclui percepção emocional e escolha forçada com duas opções. Estes 21 pacientes deprimidos foram aleatorizados em dois grupos de tratamento por 4 semanas: estimulação magnética transcraniana (EMT) ativa sobre o córtex pré-frontal dorsolateral esquerdo ( 5 Hz EMT - 120% do limiar motor) com pílula placebo e EMT placebo com 20 mg diária de fluoxetina. Os pacientes foram submetidos a um experimento de RMf cujo paradigma foi relacionado a eventos apresentação visual de faces de conteúdo emocional. Os pacientes sem depressão realizaram RMf duas vezes (teste reteste) e os deprimidos quatro vezes (duas vezes antes e duas depois do tratamento). As imagens dos pacientes com DP e depressão demonstraram menor atividade no córtex pré-frontal medial quando comparados aos pacientes com DP sem depressão. Ambos os subgrupos de pacientes com DP e depressão apresentaram melhora significativa e similar dos sintomas da depressão. Após o tratamento com EMT ativa observou-se menor atividade do giro fusiforme esquerdo, do cerebelo e do córtex pré-frontal dorsolateral direito e maior atividade do córtex pré-frontal dorsolateral esquerdo e do cíngulo anterior nas imagens de RMf quando comparados àquelas antes do tratamento. Por outro lado a fluoxetina determinou aumento da atividade do córtex pré-motor direito e do córtex pré-frontal medial direito em imagens de RMf realizadas após o tratamento. Observou-se efeito de interação entre os grupos (tempo (pré x pós) versus tipo de tratamento (fluoxetina x EMT)) no córtex préfrontal medial esquerdo sendo maior o aumento no grupo tratado com EMT. Nossos achados mostraram: 1) padrão diferente de atividade cerebral em pacientes com DP com e sem depressão; 2) efeitos antidepressivos da EMT e da fluoxetina foram semelhantes e significativos;e 3) em pacientes com DP e depressão os efeitos da EMT e fluoxetina são associados a diferentes mudanças da atividade cerebral, e em ambos as áreas encontradas são parte da rede neural relacionada à depressão. / The neural circuitry underlying depression in patients with Parkinson\'s disease (PD) is unknown, let alone the treatment effects of antidepressant therapy. Neuroimaging methods can give insights into the pathogenesis of depression and also in the mechanisms of action related to specific treatment choice. In order to evaluate differences between PD patients with and without concomitant depression we studied 21 patients with PD and depression and 16 PD patients without depression using fMRI. All patients were examined using an event-related fMRI paradigm based on visual presentation of faces with emotional content in a two options forced choice task. Furthermore the twenty-one PD depressed patients were randomized in two active treatment groups for 4 weeks: active rTMS over left dorsolateral prefrontal cortex (5 Hz rTMS - 120% motor threshold) with placebo pill and sham rTMS with fluoxetine 20 mg/day. Event-related fMRI with emotional stimuli was performed before and after treatment - in two sessions (test and re-test) at each time point. The same test-retest approach was adopted in the group of non-depressed PD patients. The analysis showed significant differences between depressed and non-depressed PD patients in the medial pre-frontal cortex, with reduced activation as detected by BOLD effect in the later group. The two groups of depressed PD patients showed a had a significant treatment effect, and with similar mood improvement. After rTMS treatment, there were brain activity decreases in left fusiform gyrus, cerebellum and right dorsolateral prefrontal cortex (DLPFC) and brain activity increases in left DLPFC and anterior cingulate gyrus as compared to baseline. In contrast, after fluoxetine treatment, there was brain activity increases in right premotor and right medial prefrontal cortex. There was a significant interaction effect between groups versus time in the left medial prefrontal cortex, suggesting that the activity in this area changed differently in the two treatment groups. Our findings show that medial prefrontal cortex is a critical area in the depression neural circuitry in PD. Antidepressant effects of rTMS and fluoxetine in PD are associated with changes in different areas of the depression-related neural network.

O circuito neuronal relacionado à depressão na doença de Parkinson (DP), assim como os efeitos da terapia antidepressiva nestes pacientes, não é bem estabelecido. Os métodos de neuroimagem podem levar ao melhor conhecimento da patogênese e também dos mecanismos de ação relacionados a um tipo específico de tratamento. Para avaliar as diferenças da atividade neuronal, comparamos 21 pacientes com DP e diagnóstico de depressão e 16 sem depressão através de ressonância magnética funcional (RMf) em uma tarefa cognitiva que inclui percepção emocional e escolha forçada com duas opções. Estes 21 pacientes deprimidos foram aleatorizados em dois grupos de tratamento por 4 semanas: estimulação magnética transcraniana (EMT) ativa sobre o córtex pré-frontal dorsolateral esquerdo ( 5 Hz EMT - 120% do limiar motor) com pílula placebo e EMT placebo com 20 mg diária de fluoxetina. Os pacientes foram submetidos a um experimento de RMf cujo paradigma foi relacionado a eventos apresentação visual de faces de conteúdo emocional. Os pacientes sem depressão realizaram RMf duas vezes (teste reteste) e os deprimidos quatro vezes (duas vezes antes e duas depois do tratamento). As imagens dos pacientes com DP e depressão demonstraram menor atividade no córtex pré-frontal medial quando comparados aos pacientes com DP sem depressão. Ambos os subgrupos de pacientes com DP e depressão apresentaram melhora significativa e similar dos sintomas da depressão. Após o tratamento com EMT ativa observou-se menor atividade do giro fusiforme esquerdo, do cerebelo e do córtex pré-frontal dorsolateral direito e maior atividade do córtex pré-frontal dorsolateral esquerdo e do cíngulo anterior nas imagens de RMf quando comparados àquelas antes do tratamento. Por outro lado a fluoxetina determinou aumento da atividade do córtex pré-motor direito e do córtex pré-frontal medial direito em imagens de RMf realizadas após o tratamento. Observou-se efeito de interação entre os grupos (tempo (pré x pós) versus tipo de tratamento (fluoxetina x EMT)) no córtex préfrontal medial esquerdo sendo maior o aumento no grupo tratado com EMT. Nossos achados mostraram: 1) padrão diferente de atividade cerebral em pacientes com DP com e sem depressão; 2) efeitos antidepressivos da EMT e da fluoxetina foram semelhantes e significativos;e 3) em pacientes com DP e depressão os efeitos da EMT e fluoxetina são associados a diferentes mudanças da atividade cerebral, e em ambos as áreas encontradas são parte da rede neural relacionada à depressão. / The neural circuitry underlying depression in patients with Parkinson\'s disease (PD) is unknown, let alone the treatment effects of antidepressant therapy. Neuroimaging methods can give insights into the pathogenesis of depression and also in the mechanisms of action related to specific treatment choice. In order to evaluate differences between PD patients with and without concomitant depression we studied 21 patients with PD and depression and 16 PD patients without depression using fMRI. All patients were examined using an event-related fMRI paradigm based on visual presentation of faces with emotional content in a two options forced choice task. Furthermore the twenty-one PD depressed patients were randomized in two active treatment groups for 4 weeks: active rTMS over left dorsolateral prefrontal cortex (5 Hz rTMS - 120% motor threshold) with placebo pill and sham rTMS with fluoxetine 20 mg/day. Event-related fMRI with emotional stimuli was performed before and after treatment - in two sessions (test and re-test) at each time point. The same test-retest approach was adopted in the group of non-depressed PD patients. The analysis showed significant differences between depressed and non-depressed PD patients in the medial pre-frontal cortex, with reduced activation as detected by BOLD effect in the later group. The two groups of depressed PD patients showed a had a significant treatment effect, and with similar mood improvement. After rTMS treatment, there were brain activity decreases in left fusiform gyrus, cerebellum and right dorsolateral prefrontal cortex (DLPFC) and brain activity increases in left DLPFC and anterior cingulate gyrus as compared to baseline. In contrast, after fluoxetine treatment, there was brain activity increases in right premotor and right medial prefrontal cortex. There was a significant interaction effect between groups versus time in the left medial prefrontal cortex, suggesting that the activity in this area changed differently in the two treatment groups. Our findings show that medial prefrontal cortex is a critical area in the depression neural circuitry in PD. Antidepressant effects of rTMS and fluoxetine in PD are associated with changes in different areas of the depression-related neural network.

背景: 近代不少西方的實證心理治療方法都開始採納東方源來已久的身心治療，來醫治常見的情緒病，例如：抑鬱症，效果最為顯著。這個發展趨勢正好回應現存醫療制度及資源的限制，或其他社會文化及個人所造成的障礙。本研究旨在檢視一種促進身心健康的中國禪宗身心治療方法 － 以「德建身心療法」對比於 「認知行為治療法」及「等候對照組」，在治療一羣抑鬱症患者的抑鬱情緒、腦功能的改善及其身体健康等的療效。 / 研究方法: 在一個精神科門診部內，研究員召集了75 名成人的抑鬱症患者。他們都是有不同程度的抑鬱情緒或身體健康問題，同時有興趣參加為期十節的「德建身心療法」或「認知行為治療法」。 在對照基本資料後 (如年齡、學歷、抑鬱程度，初患或復發) ，他們被隨機分派到「德建身心療法」、「認知行為治療法」或「等候對照組」中。治療前及治療後，抑鬱症患者都會接受情緒、腦功能、健康狀況及腦電波的評估。 / 結果: 整體而言，相對於「等候對照組」，「德建身心療法」及「認知行為治療」更有效地減低患者的抑鬱症狀。此外，「德建身心療法」更帶來一些其他組別所末見的療效；包括有效地提昇患者的專注力、記憶、執行功能、腸道功能及睡眠質素。再者、研究亦發現「德建身心療法」的參加者，在有關正面情緒和專注力的兩個客觀量化腦電波(QEEG)指數上有顯著的攀升。意外地，在短短的十星期後「德建身心療法」參加者使用抗抑鬱药的份量亦有效地減少。 / 總結: 本研究的結果顯示中國的禪宗身心治療方法 －「德建身心療法」在治療抑鬱症患者的情緒捆纏、腦功能失衡、睡眠及腸道功能、提升正面情緒及專注力的量化腦電波指數都有明顯的功效。 / BACKGROUND: There are growing interests and encouraging findings of adapting and developing Mind-Body Intervention into evidence-based group treatment for common mental disorders such as depression. The advancement is a partial response to the limitations on the availability and accessibility of the existing treatment in the current health care system for depression, and/or a partial response to the socio-cultural and personal reasons in different communities. The present study aimed to evaluate the effectiveness of a newly developed Chinese Chan-based treatment the Dejian Mind-Body Intervention (DMBI), as compared to the groups of Cognitive-behavioural Therapy (CBT) and Wait-list control, in alleviating depressive mood and improving physical health of adult depressive patients. / METHOD: Seventy-five patients with the diagnosis of Major Depressive Disorder were recruited in the current study. They were stratified for age, education, level of depression, course of illness before random assignment to receive either 10-session DMBI or CBT, or placed on a wait-list. Pre-post measurements included primary outcome measures on psychiatrists’ rating and self-evaluated mood scores (HRSD and BDI) and secondary outcome measures on performance in different neuropsychological assessment (Executive function, Attention, Memory). The three groups also compared among different sleep (SOL, TST, and WASO), gastrointestinal parameters as well as neurophysiological QEEG indices. / RESULTS: Both the DMBI and CBT groups demonstrated significant reduction in depressive psychopathology after intervention. However, the DMBI group but not the CBT or Wait-list control groups demonstrated significant improvement in attention, verbal memory, executive function, gastrointestinal health and overall sleep quality. Besides, Dejian Mind-Body Intervention brought about significant increase in objective QEEG measures of positive affect and attention that were not evidenced in the other two groups. Participants in the DMBI group also demonstrated significant reduction in the use of anti-depressant after the end of 10-week treatment. / CONCLUSIONS: Findings of the current study suggested that a Chinese Chan-based Dejian mind-body intervention has positive effects on improving the mood and health conditions of individuals with depression. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Wong, Yun Ping. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 79-109). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; some appendixes also in Chinese. / ABSTRACT --- p.iii / CHINESE ABSTRACT --- p.v / ACKNOWLEDGEMENTS --- p.vii / TABLE OF CONTENTS --- p.ix / LIST OF TABLES --- p.x / LIST OF FIGURES --- p.xii / LIST OF APPENDICES --- p.xiii / LIST OF FIGURES --- p.xii / Chapter CHAPTER I: --- INTRODUCTION --- p.1 / PURPOSES OF THE PRESENT STUDY --- p.26 / Chapter CHAPTER II: --- METHODS --- p.29 / Chapter CHAPTER III: --- RESULTS --- p.47 / Chapter CHAPTER IV: --- DISCUSSION --- p.68 / GENERAL DISCUSSION --- p.70 / CLINICAL IMPLICATIONS --- p.76 / LIMITATION AND SUGGESTIONS FOR FUTURE DIRECTION --- p.77 / REFERENCES --- p.79 / TABLES --- p.110 / FIGURES --- p.124 / APPENDICES --- p.128