مقایسه اثربخشی درمان شناختی رفتاری آمیخته با معنویت ـ دین با امیددرمانی بر علائم افسردگی پایدار زنان در سال 1401

نویسندگان
1 دانشجوی دکتری تخصصی، گروه مشاوره، واحد خمینی‌شهر، دانشگاه آزاد اسلامی، خمینی شهر، ایران
2 استادیار، گروه روانشناسی، واحد خمینی‌شهر، دانشگاه آزاد اسلامی، خمینی شهر، ایران
3 استادیار، گروه مشاوره، واحد خمینی‌شهر، دانشگاه آزاد اسلامی، خمینی شهر، ایران
چکیده
مقدمه: شیوع افسردگی در بین زنان دو برابر مردان است. افسردگی شایعترین بیماری در بین اختلالات روانپزشکی است و هزینه‌های اقتصادی زیادی را به بیمار و جامعه تحمیل می‌کند. بومی‌سازی درمان‌های رایج پرداختن برای بیمارانی که به افسردگی خوگرفته و بیماری در آن‌ها تبدیل به افسردگی پایدار شده است، حائز اهمیت است. ازاین‌رو در این پژوهش دو روش شامل: درمان شناختی رفتاری آمیخته با معنویت‌ـ‌دین و امیددرمانی مقایسه و اثربخشی هر کدام موردسنجش قرارگرفت.

روش: روش پژوهش از نوع نیمه تجربی (با طرح پیش‌آزمون و پس‌آزمون با گروه کنترل) و جامعه آماری شامل کلیه زنان دارای علائم افسردگی پایدار شهر اصفهان بودند. لذا، با روش نمونه‌گیری در دسترس و هدفمند تعداد 36 نفر انتخاب و به‌صورت تصادفی در سه گروه 12 نفره تقسیم‌بندی شدند (دو گروه درمانی به‌عنوان گروه آزمایش و یک گروه به‌عنوان کنترل) سپس از تمامی گروه‌ها پیش‌آزمون اخذ و در ادامه پروتکل‌های درمانی اجراشد. در پایان مجدداً از تمام گروه‌ها‌ پس‌آزمون اخذ و 3 ماه بعد میزان پایداری مداخلات، بررسی‌شد.

یافتهها: در این پژوهش‌ اثربخشی هر دو روش درمانی (درمان شناختی_رفتاری آمیخته با معنویت‌ـ‌دین و امیددرمانی) مورد تایید قرار گرفت منتها مقابله هر دو روش نشان داد معنویت‌درمانی اثربخشی بیشتری دارد.

نتیجهگیری: باتوجه به موثر بودن هر دو روش در کاهش افسردگی پایدار در نمونه آماری، می‌توان نتایج را به کل جامعه آماری نیز تعمیم‌داد.
کلیدواژه‌ها

عنوان مقاله English

Comparison of the Effectiveness of Cognitive-Behavioral Therapy Integrated with Spirituality-Religion Versus Hope Therapy on Persistent Depression Symptoms in Women in the year 2022

نویسندگان English

Somayeh Soleymani 1
Yousef Gorji 2
Mahmood Sharifi Esfahani 3
1 KhomeiniShahr Branch, Islamic Azad University
2 KhomeiniShahr Branch, Islamic Azad University
3 KhomeiniShahr Branch, Islamic Azad University
چکیده English

Introduction: The prevalence of depression among women is twice that of men. Depression is the most common illness among psychiatric disorders and imposes significant economic costs on patients and society. Localizing common treatments for patients who have become accustomed to depression and whose condition has developed into persistent depression is crucial. Therefore, in this study, two methods were compared: cognitive-behavioral therapy combined with spirituality-religion and hope therapy, and the effectiveness of each was assessed.

Methods: The research method was quasi-experimental (with a pretest-posttest design with a control group), and the statistical population included all women with symptoms of persistent depression in the city of Isfahan. Using accessible and purposeful sampling, 36 individuals were selected and randomly divided into three groups of 12 (two treatment groups as experimental groups and one group as a control). A pretest was conducted for all groups, followed by the implementation of therapeutic protocols. In the end, a posttest was conducted for all groups, and the stability of interventions was assessed three months later.

Results: The study confirmed the effectiveness of both therapeutic methods (cognitive-behavioral therapy combined with spirituality-religion and hope therapy); however, a comparison of both methods showed that spirituality therapy had greater effectiveness.

Conclusion: Given the effectiveness of both methods in reducing persistent depression in the sample population, the results can be generalized to the entire statistical population.

کلیدواژه‌ها English

Women's Health
Depression
Dysthymic Disorder
Positive psychology
Spiritual Therapies
1. World Health Organization. Depressive disorder (depression) [Internet]. 31 March 2023 [cited 24 January 2025][A]. Available from: [https://www.who.int/news-room/fact-sheets/detail/depression](https://www.who.int/news-room/fact-sheets/detail/depression)
2. World Health Organization. Depressive disorder (depression). 31 March 2023[B]. Available from: [https://www.who.int/news-room/fact-sheets/detail/depression](https://www.who.int/news-room/fact-sheets/detail/depression). Accessed 24 January 2025.
3. The Economic Cost of Depression is Increasing; Direct Costs are Only a Small Part. Depression, Patients and Families. May 27, 2021. Available from: [https://www.psychiatry.org/news-room/apa-blogs/the-economic-cost-of-depression-is-increasing](https://www.psychiatry.org/news-room/apa-blogs/the-economic-cost-of-depression-is-increasing). Accessed January 24, 2025.
4. Errazuriz, A., Avello-Vega, D., Ramirez-Mahaluf, J. P., Torres, R., Crossley, N. A., Undurraga, E. A., & Jones, P. B. (2023). Prevalence of depressive disorder in the adult population of Latin America: a systematic review and meta-analysis. The Lancet Regional Health - Americas, 26, 100587. https://doi.org/10.1016/j.lana.2023.100587
5. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–1222. doi:10.1016/S0140-6736(20)30925-9.
6. World Health Organization. Depression and other common mental disorders: global health estimates. Geneva: World Health Organization; 2017[C]. Licence: CC BY-NC-SA 3.0 IGO. WHO Team. Number of pages 24, WHO Reference Number: WHO/MSD/MER/2017.2.
7. Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: Findings from the Global Burden of Disease study. J Psychiatr Res. 2020;126:134-140. doi:10.1016/j.jpsychires.2019.08.002
8. Sotodeh Asl N, Gholami B, Ghorbani R. Effects of cognitive therapy, drug therapy and combined therapy in improvement of major depression.Koomesh[Internet]. 2011;13(1(41)):114-119.[Persian]
9. Butler, Gillian; Hope, Tony. (2014). Treating Depression (Psychological Cold), Translated by: Koushyar Karimi Tari. Tehran: Nasl-e-No Andish.[Persian]
10. KC, A., Chandna, J., Acharya, A., Gurung, R., Andrew, C., & Skalkidou, A. (2024). A longitudinal multi-centric cohort study assessing infant neurodevelopment delay among women with persistent postpartum depression in Nepal. BMC Medicine, 22(1), 284. https://doi.org/10.1186/s12916-024-03501-0
11. Jhangir S, Jameel R. Sociotropy-autonomy, self-criticism and self-esteem in individuals with or without depression. J Pak Med Assoc [Internet]. 2023 Oct. 30 [cited 2025 Jan. 24];73(11):2196-9. Available from: https://jpma.org.pk/index.php/public_html/article/view/8189
12. Farhadi, M., Yarmohamadi Vase, M., Zoghi Paidar, M. R., Chegin, A. A. The Efficacy of Hypnotherapy Based on Ego Strengthening on Treatment of Major Depression in Female‐Headed Households. Psychological Achievements, 2017; 24(1): 63-78. doi: 10.22055/psy.2017.16245.1429[Persian]
13. World Population Review. Title of the Article. Available from: https://worldpopulationreview.com.Accessed [2022].
14. Nezami, L., Alivandi Vafa, M., khademi, A., Babapour Kheiroddin, J. Native Modeling of Psychosocial Vulnerability to Persistent Depression of Women: A Grounded Theory Study. Quarterly Journal of Woman and Society, 2022; 12(48): 51-66. doi: 10.30495/jzvj.2021.26520.3422[Persian]
15. Lerner D, Adler D, Shayani A, Rogers WH. Research on the Tufts Be Well at Work Program for Employees With Depression: 2005–2020. Psychiatr Serv. 2021 May 7;72(12). doi: 10.1176/appi.ps.202000762.
16. WHO and ILO call for new measures to tackle mental health issues at work. Sep 28, 2022[A]. Available from: [https://www.who.int/europe/news-room/28-09-2022-who-and-ilo-call-for-new-measures-to-tackle-mental-health-issues-at-work](https://www.who.int/news/item/28-09-2022-who-and-ilo-call-for-new-measures-to-tackle-mental-health-issues-at-work). Accessed January 24, 2025.
17. WHO and ILO call for new measures to tackle mental health issues at work. Joint News Release, Geneva, Switzerland. September 28, 2022[B]. Available from: [https://www.who.int/news/item/28-09-2022-who-and-ilo-call-for-new-measures-to-tackle-mental-health-issues-at-work](https://www.who.int/news/item/28-09-2022-who-and-ilo-call-for-new-measures-to-tackle-mental-health-issues-at-work). Accessed January 24, 2025.
18. Ganji M. Psychopathology based on DSM-5, Volume 1. Savalan Publications; 2022. [Persian]
19. Gilmer, W. S., Trivedi, M. H., Rush, A. J., Wisniewski, S. R., Luther, J., Howland, R. H., Yohanna, D., Khan, A., & Alpert, J. (2005). Factors associated with chronic depressive episodes: A preliminary report from the STAR-D project. Acta Psychiatrica Scandinavica, 112(6), 425-433. https://doi.org/10.1111/j.1600-0447.2005.00633.x.
20. Substantial research has evaluated the effectiveness of spirituality-infused psychotherapies for treating general mental disorders, with some positive outcomes reported for spirituality-infused cognitive–behavioral therapies for depression or substance abuse, including mindfulness-based cognitive therapy.
21. Rosmarin, David H., author.(2018).Spirituality, religion, and cognitive-behavioral therapy : a guide for clinicians.New York : The Guilford Press,Identifiers: LCCN 2017045235| ISBN 9781462535446. P14.
22. Hosseini, Bibi Zahra; Asai-Moznabi, Abolghasem; Fallah, Mohammad Hossein. (2022). Explanation of Unified Monotheistic Personality in Integrated Monotheistic Therapy from the Perspective of Islam. Research in Religion and Health [Internet]. 2022;8(1):150-159. Available from: https://sid.ir/paper/1014142/fa.[Persian]
23. Britt KC, Acton G. Exploring the Meaning of Spirituality and Spiritual Care with Help From Viktor Frankl. J Holist Nurs. 2022 Mar;40(1):46-55. doi: 10.1177/08980101211026776. Epub 2021 Jun 24. Erratum in: J Holist Nurs. 2022 Sep;40(3):NP1-NP5. doi: 10.1177/08980101221127086. PMID: 34166126.
24. Hadi, M., & Janbozorgi, M. (2009). The effectiveness of integrated Islamic therapy on personality and clinical components. Psychology & Religion, 2(2), 71-104.[Persian]
25. Subica, A. M., & Yamada, A.-M. (2018). Development of a spirituality-infused cognitive behavioral intervention for individuals with serious mental illnesses. Psychiatric Rehabilitation Journal, 41(1), 8–15. doi:10.1037/prj0000102.p8.
26. Rahimi, E., & Maredpour, A. (2021). Development of a meaning-based suicide prevention package and its effect on life expectancy, negative spontaneous thoughts, and suicidal ideation of female students of Yasuj University of Medical Sciences in 2020. Armaghan Journal, 26(4), 684-700. http://armaghanj.yums.ac.ir/article-1-3051-fa.html. [Persian]
27. Salimi, A., Abbasi, A., Zahrakar, K., Tameh, B., & Davarniya, R. (2017). The effect of group-based hope therapy on resiliency of mothers of children with autism spectrum disorder. Armaghan Journal, 22(3), 350-363. http://armaghanj.yums.ac.ir/article-1-1763-fa.html. [Persian]
28. Santos, V., Paes, F., Pereira, V., Arias-Carrión, O., Silva, A. C., Carta, M. G., Nardi, A. E., & Machado, S. (2013). The role of positive emotion and contributions of positive psychology in depression treatment: systematic review. Clinical Practice and Epidemiology in Mental Health, 9, 221–237. https://doi.org/10.2174/1745017901309010221
29. Abdi, K., Arefi, M., Afsharinia, K., & Amiri, H. (2024). Comparison of the effectiveness of two group spiritual therapy approaches with acceptance and commitment based therapy on increasing life expectancy and happiness of cancer patients. Research Journal of Medical Sciences, 31(1), 1-11. http://rjms.iums.ac.ir/article-1-8496-fa.html. [Persian]
30. Khalili Doabi, M., Goudarzi, K., Rouzbehani, M., & Karimi, J. (2021). Comparison of the effectiveness of hope therapy and cognitive-behavioral therapy on depression of adolescent girls. Islamic Lifestyle with a Health Focus, 5(2), 118-125. Available from: https://sid.ir/paper/985763/fa.[Persian]
31. Ahmadi, S. A., Vaziri, Sh., Ahi, G., Lotfi Kashani, F., & Akbari, M. E. (2021). Comparison of the effect of Acceptance and Commitment Therapy (ACT) and spiritual therapy on reducing psychological distress (anxiety, depression, and stress) in breast cancer patients. Disability Studies, 11(1), 0-0. SID. https://sid.ir/paper/1029139/fa.[Persian]
32. Peyrovi, M., Tahmooresi, N., Nasli Esfahani, A., & Moghimbeygi, A. (2021). Comparison of the effectiveness of hope therapy and spiritual therapy on self-care behavior, depression, and HbA1c in middle-aged women with type 2 diabetes. Disability Studies, 11(1), 0-0. SID. https://sid.ir/paper/1028706/fa.[Persian]
33. Ghorbani, A., Ghezelbash, S., Alizadeh, H., & Khosravi, M. (2021). The effect of spiritual group therapy on depression, anxiety, and stress in family caregivers of children with cancer. Complementary Medicine Quarterly, 11(3), 196-209. [Persian]
34. Favale, D., Bellomo, A., Lotti, P., Bradascio, C., & Ventriglio, A. (2020). Role of hope and resilience in the outcome of depression and related suicidality. Psychology, 11, 428-435. https://doi.org/10.4236/psych.2020.113028.
35. Bloore, R., Jose, P., & Joshanloo, M. (2020). Does hope mediate and moderate the relationship between happiness aversion and depressive symptoms?. Open Journal of Depression, 9, 1-16. https://doi.org/10.4236/ojd.2020.91001.
36. Baraqai, S. S., & Roshan, R. (2020). Comparison of religious spiritual therapy and acceptance and commitment-based group therapy and their effects on reducing disgust and depressive disorder in women with obsessive-compulsive disorder. Psychology & Religion Quarterly, 13(Spring 2020), 1 (Issue 49). [Persian]
37. Eisazadeh, F., & Saffari Nia, M. (2021). The effectiveness of group spiritual therapy on depression, mental health, and psychological capital in recovering from Covid-19 disease. Quran and Medicine, 5, 11-22. [Persian]
38. Hashemian, M., Namdari, K., & Abedi, A. (2020). Effectiveness of hope therapy based on group on mental health and meaning in life in depressed female students. Quarterly Journal of Counseling Research, 19(73), 122-144. http://irancounseling.ir/journal/article-1-589-fa.html.[Persian]
39. Eiravani, F. (2020). The effectiveness of hope therapy training on behavioral competencies of clients with dysthymia in Semnan city. Available from: https://civilica.com/doc/1502951.[Persian]
40. Mason, B. J., Kocsis, J. H., Leon, A. C., Thompson, S., Frances, A. J., Morgan, R. O., & Parides, M. K. (2003). Rating scales in mental health (2nd ed.). In S. Sajatovic & L. F. Ramirez (Eds.), Tests and Measures in the Social Sciences (pp. 83-88). Hudson, OH: Lexi-Comp.
41. Snyder, C., & Lopez, S. (2009). Oxford handbook of positive psychology. USA: Oxford University Press.
42. Retnowati, S., Ramadiyanti, D. W., Suciati, A. A., Sokang, Y. A., & Viola, H. (2015). Hope intervention against depression in the survivors of cold lava flood from Merapi Mount. Social Behavior and Personality, 165, 170-178. https://doi.org/10.1016/j.sbspro.2014.12.619.
43. Thoresen, C. E., & Harris, H. S. (2002). Spirituality and health: What’s the evidence and what’s needed?. Annual Behavioral Medicine, 24(1), 3-13.
44. Brennan, M. (2004). Spirituality and religiousness predict adaptation to vision loss in middle-aged and older adults. The International Journal for the Psychology of Religion, 14(3), 193-214.
45. Sorajjakool, S., Aja, V., Chilson, B., Ramírez-Johnson, J., & Earll, A. (2008). Disconnection, depression, and spirituality: A study of the role of spirituality and meaning in the lives of individuals with severe depression. Pastoral Psychology, 56(5), 521-532. https://doi.org/10.1007/s11089-008-0125-2.
46. Desrosiers, A., & Miller, L. (2007). Relational spirituality and depression in adolescent girls. Journal of Clinical Psychology, 63(10), 1021-1037. https://doi.org/10.1002/jclp.20409.