非薬物療法の介入研究の必須事項

ᢤ ⢋ 㠀⸆≀⒪ἲ䛾௓ධ◊✲䛾ᚲ㡲஦㡯 ◊✲䛾 ᩱ ዟᮧὈஅ ዟᮧὈ ㈨ ୍⯡㈈ᅋἲே ே ་⒪⤒ ་⒪⤒῭◊✲䞉♫఍ಖ㝤⚟♴༠఍ ་⒪⤒῭◊✲ᶵᵓ ◊✲㒊 ◊✲ဨ ⒪⤒῭◊ ᪥ᮏ⾜ື⒪ἲᏛ఍➨39ᅇ኱఍ ኻᩋ䛧䛺䛔◊✲ィ⏬ධ㛛: ほᐹ◊✲䚸ᑻᗘ◊✲䚸㠀⸆≀⒪ἲ䛾௓ධ◊✲䛾◊✲ሗ ࿌䛾㉁ྥୖ䛾䛯䜑䛾䜺䜲䝗䝷䜲䞁䛾⌮ゎ 2013/8/24 (ᅵ) 15:30~17:20 ᪊: ᖇிᖹᡂ኱Ꮫụ⿄䜻䝱䞁䝟䝇

ᵓᡂ ㈨ ᩱ ᢤ ⢋ „䝉䝑䝔䜱䞁䜾䛾ヲ⣽䜢グ㍕䛩䜛 (4 min) „௓ධ䛾せ⣲䜢ᅗ♧䛩䜛 (6 mi min) „୺せホ౯㡯┠䜢Ỵ䜑䜛 min) 䜑䜛 (6 mi „᭷ᐖ஦㇟䜢 ᐃ䛩䜛 min) 䛩䜛 (4 m „⮫ᗋヨ㦂Ⓩ㘓䜢䛩䜛 㘓䜢䛩䜛 ((4 min) „↓సⅭ໬ẚ㍑ヨ㦂䛾ᐇ᪋䜢┠ᣦ䛩 (6 min) ㍑ヨ㦂 㻞

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᚲ㡲஦㡯 ᢤ ᩱ ㈨ zᅜ zᕷ z࿘ᅖ䛾⎔ቃ z᪋タᩘ z἞⒪⪅≉ᛶ ⢋ „䝉䝑䝔䜱䞁䜾 Boutron I et al: Ann Intern Med. 2008 Feb 19;148(4):295-309 Moher D et al: BMJ. 2010 Mar 23;340:c869 Chan AW et al: BMJ. 2013 Jan 8;346:e7586 㻟

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ஦౛㻦㻌ᅜ㻛᪋タᩘ㻛࿘ᅖ䛾⎔ቃ ㈨ ᩱ ᢤ ⢋ „䜶䝞䞊䝝䝹䝖䞉䜹䞊䝹኱Ꮫ (䝗䜲䝒)[ᅜ䞉᪋タᩘ] ᚰ⌮ Ꮫ⛉䛷䠈1999ᖺ8᭶䛛䜙2004ᖺ9᭶䛻⑕౛Ⓩ㘓 4ᖺ 䜢⾜䛳䛯䚹ᆅᇦ䛾⑓㝔䜔⢭⚄⛉་䛜䠈ᝈ⪅䜢⤂ ⚄⛉་ [࿘ᅖ䛾⎔ቃ]䛺 ᪂⪺䜔䝷 ௓[࿘ᅖ䛾⎔ቃ]䛧䛯䚹䜎䛯䠈᪂⪺䜔䝷䝆䜸 ཧຍ䛩䜛 䛹䛻䜘䜚䠈⮬୺ⓗ䛻ཧຍ䛩䜛⪅䜒䛔䛯䚹 Meyer TD, Hautzinger M: Psychol Med. 2012 Jul;42(7):1429-39. 㻠

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ஦౛㻦㻌᪋タᩘ㻛ᅜ㻛ᕷ㻛࿘ᅖ䛾⎔ቃ ㈨ ᩱ ᢤ ⢋ „ᮏ◊✲䛿䠈䝃䞁䝖䠙䝬䝹䜾䝸䝑䝖኱Ꮫ⑓㝔[᪋タᩘ]䛷 䛾䝬䝹䝉䜲䝴[ᕷ]䛻䛒 ᐇ᪋䛧䛯䚹䛣䛣䛿䠈䝣䝷䞁䝇[ᅜ]䛾䝬 䜛⢭⚄⛉ᑓ㛛[࿘ᅖ䛾⎔ቃ]䛾䝉䞁䝍䞊䛷䛒䜛䚹6䛛᭶ 䝉䞁䝍䞊 䛶䛔䜛ᝈ ௨ୖ䝕䜲䜿䜰䛻㏻ᡤ䛧䛶䛔䜛ᝈ⪅䜢㐃⥆ᢳฟ䛧䛯䚹 Boyer L et al: Br J Psychiatry. 2013 Jun;202:447-53 㻡

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ஦౛㻦㻌἞⒪⪅≉ᛶ „ᮏ◊✲䛾䝉䝷䝢䝇䝖䛿䠈≀㉁౑⏝㞀ᐖ䛾ㄆ▱⾜ 䝟 ື⒪ἲ䛾ṇᘧ䛺カ⦎䛸䝇䞊䝟䞊䝡䝆䝵䞁䜢ཷ䛡䠈 䛩䜛⪅䛷 8ᖺ௨ୖ䛾⮫ᗋ⤒㦂䜢᭷䛩䜛⪅䛷䛒䛳䛯䚹䛥䜙䛻䠈 ὀពḞ㝗 䛩䜉䛶䛾䝉䝷䝢䝇䝖䛿䠈ὀពḞ㝗ከືᛶ㞀ᐖ䛾 ⑕≧䜢ᶆⓗ䛸䛧䛯ㄆ▱⾜ື⒪ἲ䛾4᫬㛫䛻䜟䛯䜛 ▱⾜ື⒪ カ⦎䜢ཷ䛡䛯䚹◊✲ᮇ㛫䛾㛫䠈⤒㦂㇏ᐩ䛺䝇䝍䝑 ◊✲ᮇ㛫 㐌䠈䝇䞊䝟 䝣 (E.V.) 䛜ẖ㐌䠈䝇䞊䝟䞊䝡䝆䝵䞁䜢⾜䛳䛯䚹 van Emmerik-van Oortmerssen K et al: BMC Psychiatry. 2013 May 10;13:132. 㻢

ᵓᡂ ㈨ ᩱ ᢤ ⢋ „䝉䝑䝔䜱䞁䜾䛾ヲ⣽䜢グ㍕䛩䜛 (4 min) „௓ධ䛾せ⣲䜢ᅗ♧䛩䜛 (6 mi min) „୺せホ౯㡯┠䜢Ỵ䜑䜛 min) 䜑䜛 (6 mi „᭷ᐖ஦㇟䜢 ᐃ䛩䜛 min) 䛩䜛 (4 m „⮫ᗋヨ㦂Ⓩ㘓䜢䛩䜛 㘓䜢䛩䜛 ((4 min) „↓సⅭ໬ẚ㍑ヨ㦂䛾ᐇ᪋䜢┠ᣦ䛩 (6 min) ㍑ヨ㦂 㻣

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᚲ㡲஦㡯 „௓ධ䛾せ⣲ ⢋ z㉁ⓗ䛺᝟ሗ ㈨ ᩱ ᢤ • ྛ䝉䝑䝅䝵䞁䛾ෆᐜ ᅋ/㟁ヰ) • ᐇ᪋ᙧែ (ಶே/㞟ᅋ/㟁ヰ) 䞁䛾᭷↓ • 䝇䞊䝟䞊䝡䝆䝵䞁䛾᭷↓ 䛩᝟ሗ䛾 • ᝈ⪅䛸஺䜟䛩᝟ሗ䛾ෆᐜ • ᝟ሗ䜢஺䜟䛩䛸䛝䛻౑⏝䛧䛯㐨ල 䛩䛸䛝䛻 Boutron I et al: Ann Intern Med. 2008 Feb 19;148(4):295-309 㻤

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᚲ㡲஦㡯 „௓ධ䛾せ⣲ ⢋ z㔞ⓗ䛺᝟ሗ ㈨ ᩱ ᢤ • 䝉䝑䝅䝵䞁䛾ᅇᩘ • 䝉䝑䝅䝵䞁䛾㛫㝸 㛫 • 䝉䝑䝅䝵䞁䛾᫬㛫 䛾୺䛺せ • ྛ䝉䝑䝅䝵䞁䛾୺䛺せ⣲䛻๭䛟᫬㛫 • ඲య䛾௓ධᮇ㛫 ධᮇ㛫 Boutron I et al: Ann Intern Med. 2008 Feb 19;148(4):295-309 㻥

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᩱ ᢤ ⢋ 㻼㼍㼞㼠㼟㻌㼍㼚㼐㻌㼀㼕㼙㼕㼚㼓㻌㻔㻼㼍㼀㻕㻌㻼㼘㼛㼠 Perera R et al: BMJ. 2007 Jan 20;334(7585):127-9 㻝㻜

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 㻼㼍㼞㼠㼟㻌㼍㼚㼐㻌㼀㼕㼙㼕㼚㼓㻌㻔㻼㼍㼀㻕㻌㻼㼘㼛㼠 ᢤ ⢋ ᑐ↷⩌ ㈨ ๭௜᫬ ௓ධ⩌ ධ⩌ ᩱ 䝍䜲䝮䝷䜲䞁 ᇶ‽᫬ Perera R et al: BMJ. 2007 Jan 20;334(7585):127-9 㻝㻝

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 㻼㼍㼞㼠㼟㻌㼍㼚㼐㻌㼀㼕㼙㼕㼚㼓㻌㻔㻼㼍㼀㻕㻌㻼㼘㼛㼠 ㈨ ᩱ ᢤ ab b-c-dྠ᫬ c-d Perera R et al: BMJ. 2007 Jan 20;334(7585):127-9 㻝㻞

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 㻼㼍㼞㼠㼟㻌㼍㼚㼐㻌㼀㼕㼙㼕㼚㼓㻌㻔㻼㼍㼀㻕㻌㻼㼘㼛㼠 b ᅛᐃ໬ 䛧䛯せ⣲ c ㆤᖌ䛻䜘䜛3 ᝈ⪅䛸┳ㆤᖌ䛻䜘䜛30-40ศ㛫䛾ᵓ㐀໬㠃᥋䜢 ┳ㆤᖌ䛿஧ḟ ⾜䛖䚹┳ㆤᖌ䛿஧ḟண㜵䛾༑ศ䛺⤒㦂䜢᭷䛩 .. ୰␎)...ᝈ 䜛䚹...(୰␎)...ᝈ⪅䛾ᚰ⑌ᝈ䛾䝸䝇䜽ᅉᏊ䜢⪺䛝 ฟ䛧䠈ᨵၿ䛩 ฟ䛧䠈ᨵၿ䛩䜛䛯䜑䛾⏕ά⩦័䜢ᥦ᱌䛩䜛䚹 㠃᥋䛾㛫 㠃᥋䛾㛫䠈70㡫䛾⊃ᚰ⑕䛾䛯䜑䛾䝽䞊䜽䝤䝑䜽 䜢Ώ䛩䚹䝽䞊䜽䝤䝑䜽䛿䠈ㄆ▱⾜ື⒪ἲ䜢ᛂ⏝䛧 䛩 䛯䜒䛾䛷䠈୙㐺ษ䛺ᑐฎ⾜ື䜢ኚ䛘䛶䠈㞀ᐖ䛾㐍 ⾜䜢Ṇ䜑䜛䛣䛸䜢┠ⓗ䛸䛧䛶䛔䜛䚹 ㈨ ⮬⏤ᗘ䛾 䛒䜛せ⣲ ᝈ⪅䛜⊃ᚰ⑕䛾⌮ゎ䛻㛵䛩䜛㉁ၥ⣬䛻グධ䛩䜛䚹 ⌮ゎ䛻㛵 ᢤ ⢋ a ᩱ ᅛᐃ໬ 䛧䛯せ⣲ Perera R et al: BMJ. 2007 Jan 20;334(7585):127-9 㻝㻟

ᵓᡂ ㈨ ᩱ ᢤ ⢋ „䝉䝑䝔䜱䞁䜾䛾ヲ⣽䜢グ㍕䛩䜛 (4 min) „௓ධ䛾せ⣲䜢ᅗ♧䛩䜛 (6 mi min) „୺せホ౯㡯┠䜢Ỵ䜑䜛 min) 䜑䜛 (6 mi „᭷ᐖ஦㇟䜢 ᐃ䛩䜛 min) 䛩䜛 (4 m „⮫ᗋヨ㦂Ⓩ㘓䜢䛩䜛 㘓䜢䛩䜛 ((4 min) „↓సⅭ໬ẚ㍑ヨ㦂䛾ᐇ᪋䜢┠ᣦ䛩 (6 min) ㍑ヨ㦂 㻝㻠

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᚲ㡲஦㡯 ㈨ • ᮏே/ᐙ᪘ ᩱ zᑻᗘྡ zᑻᗘ㑅ᢥ䛾⌮⏤ zᑻᗘ≉ᛶ z᝟ሗ※ ᢤ ⢋ „ホ౯㡯┠䛾ᐃ⩏ Moher D et al: BMJ. 2010 Mar 23;340:c869 Chan AW et al: BMJ. 2013 Jan 8;346:e7586 Calvert M et al: JAMA. 2013 Feb 27;309(8):814-22. 㻝㻡

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᚲ㡲஦㡯 z཰㞟ἲ ᢤ ⢋ „ホ౯㡯┠䛾ᐃ⩏ • ⣬/㠃᥋/㟁ヰ/Web zホ౯᫬Ⅼ zᝈ⪅䝺䝧䝹䛾༢఩ ఩ • ኚ໬㔞/᭱⤊ホ౯᫬䛾್/䜲䝧䞁䝖Ⓨ⏕䜎䛷䛾᫬㛫 ⤊ホ౯᫬䛾 z㞟ᅋ䝺䝧䝹䛾༢఩ 䛾༢఩ • ᖹᆒ್/(ᐶゎ䛾)ẚ⋡ Moher D et al: BMJ. 2010 Mar 23;340:c869 Chan AW et al: BMJ. 2013 Jan 8;346:e7586 Calvert M et al: JAMA. 2013 Feb 27;309(8):814-22. 㻝㻢

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ୺せホ౯㡯┠䛾ཎ๎ „᭱䜒㔜せ䛺䜒䛾1䛴 ⢋ zᝈ⪅-἞⒪⪅-ᨻ⟇Ỵᐃ⪅䛻䛸䛳䛶㔜せ 䛻䛸䛳 ᢤ „1䛴䛻⤠䜛⌮⏤ ᩱ z᳨ᐃ䛾ከ㔜ᛶ䛾㜵Ṇ 㜵Ṇ z㑅ᢥⓗ䛺ሗ࿌䛾㜵Ṇ 䛾㜵Ṇ z◊✲┠ⓗ z౛ᩘタィ ㈨ „ホ౯㡯┠䛾཯ᫎඛ ཯ᫎඛ 㻝㻣

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ஦౛㻦㻌ホ౯᫬Ⅼ㻛཰㞟ἲ㻛ᑻᗘྡ ㈨ ᩱ ᢤ ⢋ „୺せホ౯㡯┠䛿䠈἞⒪⤊஢1ᖺᚋ[ホ౯᫬Ⅼ]䛾 PTSD䛾㔜⑕ᗘ䛾ኚ໬䛸䛧䛯䚹 䛯䚹 „PTSD䛾デ᩿䛸㔜⑕ᗘホᐃ䛾䛯䜑䛻䠈⮫ᗋᐙ䛻 ᐃ䛾䛯䜑 䛒䜛䠈CAP (Clinician䜘䜛ホ౯ᑻᗘ[཰㞟ἲ]䛷䛒䜛䠈CAPS Administered PTSD Scale) ale) [ᑻᗘྡ]䜢 䜢฼⏝䛧䛯䚹ᩥ⊩ Ertl V et al: JAMA. 2011 Aug 3;306(5):503-12. 㻝㻤

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ஦౛㻦㻌ᑻᗘ≉ᛶ ㈨ ᩱ ᢤ ⢋ „ホᐃ⪅㛫୍⮴⋡䛿0.90௨ୖ䠈ෆⓗ୍㈏ᛶ䛿0.80 ௨ୖ䛷䛒䜛䛣䛸䛜ሗ࿌䛥䜜䛶䛔䜛䚹 䛔䜛 ᩥ⊩ ᮏ◊✲䛷 .88䛷䛒 䛾䜽䝻䞁䝞䝑䜽䛾ಀᩘ䛿0.88䛷䛒䛳䛯䚹CAPS䛾 ኚ໬䛜䠈⮫ స⪅䛻䜘䜛䛸䠈15Ⅼ䛾ኚ໬䛜䠈⮫ᗋⓗព࿡䛾䛒 䜛ኚ໬䛸䛥䜜䛶䛔䜛䚹ᩥ⊩ Ertl V et al: JAMA. 2011 Aug 3;306(5):503-12. 㻝㻥

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ஦౛㻦㻌ᝈ⪅㻛㞟ᅋ䝺䝧䝹䛾༢఩ ༢఩ ኚ໬㔞䛾ᖹᆒ್ ኚ໬㔞 㔞 -26 -2 ᝈ⪅䝺䝧䝹䛾༢఩ ᩱ ἞⒪๓ 1ᖺᚋ 76 50 80 78 ㈨ ᝈ⪅ A B ᢤ ⢋ „ኚ໬㔞 (1ᖺᚋ-἞⒪๓)[ᝈ⪅䝺䝧䝹䛾༢఩] 䛾ᖹᆒ್ ᕪ[㞟ᅋ䝺䝧䝹䛾༢఩]䛾グ㏙ⓗ䛺ศᯒ䛸䛧䛶䠈἞⒪᏶㐙 ศᯒ ⪅䛾᝟ሗ䜢ᇶ䛻䠈⊂❧䛺2⩌䛾t᳨ᐃ䜢ᐇ᪋䛧䛯䚹 ⩌䛾t᳨ ἞⒪⩌ ἞⒪⩌ -32.36 ᚅᶵ⩌ -19.32 㞟ᅋ䝺䝧䝹䛾༢఩ ኚ໬㔞䛾ᖹᆒ್ᕪ = 14.06 (32.36-19.32) Ertl V et al: JAMA. 2011 Aug 3;306(5):503-12. 㻞㻜

ᵓᡂ ㈨ ᩱ ᢤ ⢋ „䝉䝑䝔䜱䞁䜾䛾ヲ⣽䜢グ㍕䛩䜛 (4 min) „௓ධ䛾せ⣲䜢ᅗ♧䛩䜛 (6 mi min) „୺せホ౯㡯┠䜢Ỵ䜑䜛 min) 䜑䜛 (6 mi „᭷ᐖ஦㇟䜢 ᐃ䛩䜛 min) 䛩䜛 (4 m „⮫ᗋヨ㦂Ⓩ㘓䜢䛩䜛 㘓䜢䛩䜛 ((4 min) „↓సⅭ໬ẚ㍑ヨ㦂䛾ᐇ᪋䜢┠ᣦ䛩 (6 min) ㍑ヨ㦂 㻞㻝

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᚲ㡲஦㡯 „᭷ᐖ஦㇟ ᢤ ⢋ z஦㇟䛾ᐃ⩏ z ᐃ᪉ἲ䛾グ㏙ ㈨ ᩱ arm) = ἞ ὀ) ᭷ᐖ஦㇟ (harm) ἞⒪䛻䜘䛳䛶⏕䛨䜛ྍ⬟ ព䛻ἢ䜟䛺 ᛶ䛾䛒䜛䠈ព䛻ἢ䜟䛺䛔䛩䜉䛶䛾⤖ᯝ䚹἞⒪䛸 ᅉᯝ㛵 ᭷ᐖ஦㇟䛾ᅉᯝ㛵ಀ䛿ၥ䜟䛺䛔䚹 Ioannidis JP et al: Ann Intern Med. 2004 Nov 16;141(10):781-8. 㻞㻞

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᚰ⌮⒪ἲ䛾᭷ᐖ஦㇟ „⮬ẅᮍ㐙[1] „⢭⚄⛉ධ㝔[1] 1 „᭚㟢⒪ἲ䛻䛚䛡䜛୙Ᏻ⑕≧ ୙Ᏻ⑕≧[1] [2] „≀㉁஘⏝⪅䛾ឤ᝟⾲ฟ䛻క䛖ᩛព ᝟⾲ฟ䛻 3 „἞⒪⪅䛸䛾ᛶⓗ㛵ಀ ⓗ㛵ಀ[3] [1] Peterson AL et al: Contemp Clin Trials. 2013 Jan;34(1):152-4 [2] Berk M, Parker G: Aust N Z J Psychiatry. 2009 Sep;43(9):787-94 [3] Nutt DJ, Sharpe M: J Psychopharmacol. 2008 Jan;22(1):3-6 㻞㻟

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ஦౛㻦㻌ᮍᡂᖺ䛾≀㉁஘⏝䛾᭷ᐖ஦㇟ Ỵᐃ ㆤ⪅䛜⾜ ಖㆤ⪅䛜⾜᪉䜢ᢕᥱ䛧䛯 ᫬Ⅼ ᫂░䛺 ᫂░䛺ᐃ⩏䛜Ꮡᅾ ᭀຊ ᭀຊ⾜Ⅽ䛾⤊஢ᚋ䛻Ỵᐃ ⢭⚄་⒪䛾ᑓ㛛ᐙ䛜Ỵᐃ ㈨ ᩱ ᢤ ⢋ ஦㇟ ᐃ⩏ ᐙฟ 1᪥䠈ᖐᏯ䛧䛺䛔䠈 ⾜᪉䜢ゝ䜟䛺䛔 ೵Ꮫ ೵Ꮫ䛩䜛 䜛 ᭀຊ ᭀຊ䜢ཷ䛡䜛 ⮬യ ⮬യ⾜Ⅽ Horigian VE et al: Clin Trials. 2010 Feb;7(1):58-68. 㻞㻠

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ஦౛㻦㻌⤫ྜኻㄪ⑕䛾᭷ᐖ஦㇟ ᢤ ⢋ „⮬ẅ᪤㐙 „⮬ẅᮍ㐙 „⮬ẅᛕ៖ ㈨ „⑕≧䛾ᝏ໬ ᩱ z䛖䛴⑓䛾௚⪅ホᐃᑻᗘ ᐃᑻᗘ (C (CDSS) 䛾⮬ẅᛕ៖ 䛾㡯┠䛜2Ⅼ௨ୖ (0~3Ⅼ) ௨ୖ (0~3 z⮫ᗋ඲⯡༳㇟ᗘ ᗘ (CGI) 䛾඲⯡ⓗ㔜⑕ᗘ䛸඲ ⯡ⓗᨵၿᗘ䛾2㡯┠䛜6Ⅼ௨ୖ (0~7Ⅼ) Klingberg S et al: J Nerv Ment Dis. 2012 Jul;200(7):569-76 㻞㻡

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᵓᡂ ㈨ „䝉䝑䝔䜱䞁䜾䛾ヲ⣽䜢グ㍕䛩䜛 (4 min) „௓ධ䛾せ⣲䜢ᅗ♧䛩䜛 (6 mi min) „୺せホ౯㡯┠䜢Ỵ䜑䜛 min) 䜑䜛 (6 mi „᭷ᐖ஦㇟䜢 ᐃ䛩䜛 min) 䛩䜛 (4 m „⮫ᗋヨ㦂Ⓩ㘓䜢䛩䜛 㘓䜢䛩䜛 ((4 min) „↓సⅭ໬ẚ㍑ヨ㦂䛾ᐇ᪋䜢┠ᣦ䛩 (6 min) ㍑ヨ㦂 㻞㻢

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᚲ㡲஦㡯 „⮫ᗋヨ㦂Ⓩ㘓 z䝅䝇䝔䝮䛾ྡ⛠ ᩱ zⓏ㘓␒ྕ ᢤ ⢋ • UMIN Clinical Trials Registry gistry • ClinicalTrials.gov ㈨ ὀ) ⮫ᗋヨ㦂 (Clinica (Clinical Trial) = 1䛴௨ୖ䛾೺ᗣ 䛾 㛵㐃䛾௓ධἲ䛾ຠᯝ䜢☜ㄆ䛩䜛䛯䜑䛻䠈䝠䝖䜢 ྛ௓ධἲ䛻๭䜚௜䛡䛶ᐇ᪋䛩䜛๓ྥ䛝◊✲ Moher D et al: BMJ. 2010 Mar 23;340:c869 Chan AW et al: BMJ. 2013 Jan 8;346:e7586 㻞㻣

ᵓᡂ ㈨ ᩱ ᢤ ⢋ „䝉䝑䝔䜱䞁䜾䛾ヲ⣽䜢グ㍕䛩䜛 (4 min) „௓ධ䛾せ⣲䜢ᅗ♧䛩䜛 (6 mi min) „୺せホ౯㡯┠䜢Ỵ䜑䜛 min) 䜑䜛 (6 mi „᭷ᐖ஦㇟䜢 ᐃ䛩䜛 min) 䛩䜛 (4 m „⮫ᗋヨ㦂Ⓩ㘓䜢䛩䜛 㘓䜢䛩䜛 ((4 min) „↓సⅭ໬ẚ㍑ヨ㦂䛾ᐇ᪋䜢┠ᣦ䛩 (6 min) ㍑ヨ㦂 㻟㻝

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 䜶䝡䝕䞁䝇䛾㉁䛾ホ౯ ほᐹ◊✲ ⢋ ᢤ ㈨ ᩱ ↓సⅭ໬ ẚ㍑ヨ㦂 䝺䝧䝹 䜶䝡䝕䞁䝇䛾✀㢮 1++ ㉁䛾㧗䛔䝯䝍䞉䜰䝘䝸䝅䝇䠈RCT䛾⣔⤫ⓗᒎᮃ䠈 䝞䜲䜰䝇䛾䝸䝇䜽䛜㠀ᖖ䛻ᑠ䛥䛔RCT 1+ Ⰻ䛟䛷䛝䛯䝯䝍䞉䜰䝘䝸䝅䝇, RCT䛾⣔⤫ⓗᒎ ᮃ, 䝞䜲䜰䝇䛾䝸䝇䜽䛜ᑠ䛥䛔RCT 1- 䝯䝍䞉䜰䝘䝸䝅䝇, RCT䛾⣔⤫ⓗᒎᮃ, 䝞䜲䜰 䝇䛾䝸䝇䜽䛜኱䛝䛔RCT 2++ 䝞䜲䜰䝇䛾䝸䝇䜽䛜㠀ᖖ䛻ᑠ䛥䛔ほᐹ◊✲䛾 ⣔⤫ⓗᒎᮃ 2+ 䝞䜲䜰䝇䛾䝸䝇䜽䛜ᑠ䛥䛔ほᐹ◊✲ 2- 䝞䜲䜰䝇䛾䝸䝇䜽䛜኱䛝䛔ほᐹ◊✲ 3 ⑕౛䝅䝸䞊䝈◊✲ 4 ᑓ㛛ᐙ䛾ពぢ AHRQ: http://www.guideline.gov/content.aspx?id=39324 㻟㻞

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 ᥎ዡᗘ䛾ホ౯ ㈨ ᩱ ᢤ ⢋ ᥎ዡᗘ ᥎ዡ䛾✀㢮 A 䞉1䛴௨ୖ䛾䛂1++䛃䛾◊✲ 䞉኱㒊ศ䛾◊✲䛿䛂1+䛃䛷୍㈏䛧䛯⤖ᯝ B 䞉኱㒊ศ䛾◊✲䛿䛂2++䛃䛷୍㈏䛧䛯⤖ᯝ 䞉䛂1++䛃䛂1+䛃䛾ᑐ㇟㞟ᅋ䛛䜙እᤄ C 䞉኱㒊ศ䛾◊✲䛿䛂2+䛃䛷୍㈏䛧䛯⤖ᯝ 䞉䛂2++䛃䛾ᑐ㇟㞟ᅋ䛛䜙እᤄ D 䞉䛂3䛃䛂4䛃䛾◊✲ 䞉䛂2+䛃䛾ᑐ㇟㞟ᅋ䛛䜙እᤄ GPP 䜺䜲䝗䝷䜲䞁䛾䝏䞊䝮ෆ䛷䛾ពぢ AHRQ: http://www.guideline.gov/content.aspx?id=39324 㻟㻟

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 䛖䛴⑓἞⒪䛾䜶䝡䝕䞁䝇䛾㉁䛸᥎ዡᗘ „䛩䜉䛶䛾ᢠ䛖䛴⸆䛿䠈୍ᗘ㛤ጞ䛧䛯䜙䠈ᑡ䛺䛟䛸䜒 4~6㐌㛫⥅⥆䛩䜉䛝䛷䛒䜛 ㈨ ᩱ ᢤ ⢋ z䜶䝡䝕䞁䝇䛾㉁ 2+ (䝞䜲䜰䝇䛜ᑠ䛥䛔ほᐹ◊✲) z᥎ዡ䛾ᙉ䛥: C AHRQ: http://www.guideline.gov/content.aspx?id=39324 㻟㻠

७ॵॸॕথॢ ஂোभਏಞ ௬੼ඨ৯ થ૩হ଴ ఃஈ 5&7 䛖䛴⑓἞⒪䛾䜶䝡䝕䞁䝇䛾㉁䛸᥎ዡᗘ ᢤ ⢋ „࿘⏘ᮇ䛾䛖䛴⑓ᝈ⪅䜈䛿䠈ᚰ⌮⒪ἲ䜢➨1㑅ᢥ 䛾἞⒪ἲ䛸䛧䛶⪃៖䛩䜉䛝䛷䛒䜚䠈ᢠ䛖䛴⸆䛻䜘 䛷䛒䜚 䛝䛷䛒䜛 䜛἞⒪䛿㔜⑕౛䛻㝈䜛䜉䛝䛷䛒䜛 ㈨ ᩱ z䜶䝡䝕䞁䝇䛾㉁ 4 (ᑓ㛛ᐙ䛾ពぢ) z᥎ዡ䛾ᙉ䛥: D AHRQ: http://www.guideline.gov/content.aspx?id=39324 㻟㻡

㼀㼍㼗㼑㻌㻴㼛㼙㼑㻌㻹㼑㼟㼟㼍㼓㼑㼟 ㈨ ᩱ ᢤ ⢋ „䝉䝑䝔䜱䞁䜾䛾ヲ⣽䜢グ㍕䛩䜛 „௓ධ䛾せ⣲䜢ᅗ♧䛩䜛 „୺せホ౯㡯┠䜢Ỵ䜑䜛 䜑䜛 „᭷ᐖ஦㇟䜢 ᐃ䛩䜛 䛩䜛 „⮫ᗋヨ㦂Ⓩ㘓䜢䛩䜛 㘓䜢䛩䜛 „↓సⅭ໬ẚ㍑ヨ㦂䛾ᐇ᪋䜢┠ᣦ䛩 ㍑ヨ㦂 㻟㻣