うつ病のためのメタ認知トレーニングと作業療法の併用により思考パターンと援助希求行動に変化がみられたうつ病の一事例

A case of depression in which a combination of metacognitive training for depression and occupational therapy resulted in changes in thought patterns and help-seeking behavior

要旨：家族を亡くした喪失感と生活への不安から抑うつ状態となり，援助希求行動が取れず自殺企図に至ったうつ病患者に関わる機会を得た．うつ病患者に特徴的な思考の歪みに気づくこと，問題が持続した場合に援助希求行動が取れることを目標に，うつ病のためのメタ認知トレーニング（D-MCT）と精神科作業療法（OT）を実施した．9週間の介入の結果，D-MCTを通して思考の歪みに気付き，OTを通して気分の安定，自尊心の向上が見られた．特に思考の歪みの気付きと自尊心の向上は相乗的に影響を与え，援助希求行動に繋がったため報告する．

　We had the opportunity to work with a patient who was depressed due to the loss of her family and anxiety about her life. She was unable to engage in help-seeking behavior, which led to a suicide attempt. Metacognitive Training for Depression (D-MCT) and psychiatric occupational therapy (OT) were implemented to help the patient become aware of distortions in her thinking which are typical of depressed patients. The training also served to encourage help-seeking behavior when the distortions persisted. The results of the 9-week intervention showed that the patient became aware of distortions in her thinking through D-MCT, and stabilized her mood through OT, both of which improved her self-esteem. In particular, awareness of distortions in thinking and improvements in self-esteem had a synergistic effect, and changes in behaviors such as seeking help were observed.