简化认知行为治疗对抑郁症患者生活质量的 影响
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国家重点研发计划(2018YFC2001605);上海市2015 年度科学技术委员会科研计划项目 (15411950200);上海市精神卫生中心院级课题(2019-YJ14)


Effect of simplified cognitive behavioral therapy on the quality of life in patients with major depressive disorder
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    摘要:

    目的 比较简化认知行为治疗(SCBT)联合药物、支持性心理治疗(SP)联合药物以及单纯 药物治疗3 种干预方式对抑郁症患者生活质量的影响。方法 采用随机对照试验设计,将120 例抑郁症 患者随机分配至SCBT+药物组、SP+药物组和单纯药物组,进行8 周治疗,12 周随访。采用健康状况调 查问卷从8 个维度评估患者生活质量。结果 纳入统计分析94 例,3 组分别为34 例、32 例、28 例。3 组 在社会人口学资料、发病形式、病程、抑郁程度等方面差异无统计学意义(P > 0.05)。基线时,3 组在生 理机能、一般健康状况和社会功能方面差异有统计学意义(P<0.05),单纯药物组得分较低;干预结束时, SCBT+药物组在一般健康状况上得分高于SP+药物组(F=3.695,P=0.026),在精神健康上得分高于单纯药 物组(F=8.409,P< 0.05);12 周末,SCBT+ 药物组在生理职能上得分高于单纯药物组(F=3.606,P=0.028), 在一般健康状况上得分高于SP+药物组(F=4.762,P=0.009),在精力维度(F=4.725, P=0.010)和精神健 康维度(F=12.066,P< 0.05)上得分高于另外两组。组内比较结果显示,SCBT+药物组在生活质量8 个 维度上差异均有统计学意义(P< 0.05);SP+药物组及单纯药物组在3 个维度差异有统计学意义(P < 0.05)。结论 SCBT联合药物治疗、SP联合药物治疗和单纯药物治疗均能有效改善抑郁症患者生活质量, SCBT 联合药物治疗在改善抑郁症患者生理职能、一般健康状况、精力和精神健康方面效果更好。

    Abstract:

    Objective To compare the effects of simplified cognitive behavioral therapy( SCBT) combined with medication, supportive psychotherapy( SP) combined with medication, and medication therapy alone on the quality of life in patients with major depressive disorder. Methods A randomized controlled trial design was adopted. A total of 120 patients with major depressive disorder were randomly divided into SCBT combined with medication group, SP combined with medication group and medication group. Eight weeks treatment and 12 weeks follow-up were carried out. The quality of life of patients was evaluated from 8 dimensions by health status questionnaire. Rusults Totals of 94 cases were included in the statistical analysis. The number of patients in the three groups were 34, 32 and 28. There were no statistically significant differences in sociodemographic factors, onset patterns, the progression of the disease, and the severity of depression among the three groups( P > 0.05). At baseline, the differences of physical function, general health status, and social function were statistically significant( P<0.05) among the 3 groups and the score of medication group was lower. At the end of the intervention, the general health status score of SCBT combined with medication group was higher than that of the SP combined with medication group in( F=3.695, P=0.026), and the mental health score was higher than that of the medication group( F=8.409, P< 0.05). At the end of the 12 weeks, the physiological function score of the SCBT combined with medication group was higher than that of the medication group( F=3.606, P=0.028). The general health status score was higher than that of the SP combined with medication group( F=4.762, P=0.009). The scores of vitality dimension( F=4.725,P=0.010) and mental health dimension( F=12.066, P<0.05) were higher than those of the other two groups. The results of comparison among groups showed that there were statistically significant differences in all 8 dimensions of the life quality in the SCBT combined with medication group( P < 0.05). There were statistically significant differences in 3 out of 8 dimensions in the SP combined with medication group and the medication group( P< 0.05). Conclusions SCBT combined with medication therapy, SP combined with medication therapy and medication therapy alone can effectively improve the quality of life of patients with major depressive disorder. SCBT combined with medication therapy is more effective on improving physical function, general health status, vitality and mental health of patients with major depressive disorder.

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罗金晶 徐辕虹 师彬彬 杨璧西 李春波.简化认知行为治疗对抑郁症患者生活质量的 影响[J].神经疾病与精神卫生,2021,21(1):
DOI :10.3969/j. issn.1009-6574.2021.01.001.

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  • 在线发布日期: 2021-03-01