认知行为治疗合并抗抑郁药对抑郁症残留症状的影响
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摘要
目的研究认知行为治疗与抗抑郁药物联合应用于抑郁症残留症状患者中的临床效果,以为抑郁症残留症状的临床治疗提供借鉴。方法选取2013年7月至2017年6月收治的治疗后有相关抑郁症残留症状的患者94例,根据随机数表法患者分成2组。参照组给予抗抑郁药物治疗,研究组在参照组治疗基础上,给予认知行为治疗,治疗24周后,对比2组患者治疗前后的抑郁因子评分、焦虑因子评分及睡眠障碍因子评分,对比2组患者治疗前后TCSQ量表各维度评分,自动思维问卷(ATQ)评分及治疗有效率。结果治疗前,2组患者的抑郁因子评分、焦虑因子评分及睡眠障碍因子评分比较差异均无统计学意义(P>0.05)。治疗后,2组患者各项因子评分较治疗前均明显下降,且研究组明显优于参照组(P<0.05)。治疗前,2组患者TCSQ量表的积极应对维度评分、消极应对维度评分比较差异均无统计学意义(P>0.05);治疗后,2组患者TCSQ量表的积极应对维度评分明显提高,消极应对维度评分明显下降,且研究组明显优于参照组(P<0.05)。治疗前,2组患者ATQ评分比较差异无统计学意义(P>0.05);治疗后,2组患者ATQ评分均明显下降,且研究组较参照组评分下降幅度更明显(P<0.05)。研究组治疗总有效率为78.72%,参照组治疗总有效率为61.70%,研究组显著高于参照组(P<0.05)。结论给予抑郁症残留症状患者认知行为治疗联合抗抑郁药物治疗,能有效改善相关症状,是理想的治疗方案,值得推广。
Objective To investigate the clinical curative effects of cognitive behavioral therapy(CBT) combined with antidepressants on residual symptoms of patients with residual symptoms of depression,so as to provide references for thetreatment of the disease.Methods A total of 94 patients with residual symptoms of depression who were treated in our hospital from July 2013 to June 2017 were enrolled in the study,who were divided into control group and research group according to random digital table.The patients in control group were treated by antidepressant drugs,however,the patients in research group,on the basis of control group,were treated by CBT.After 24-week treatment the depression factor score,anxiety factor score and sleep disorder factor score were observed and compared between the two groups,moreover, the TCSQ scale scores,automatic thinking questionnaire(ATQ) score and treatment efficiency were observed and compared between the two groups.Results Before treatment,there were no significant differences in depression factor scores,anxiety factor scores and sleep disorder factor scores between the two groups(P>0.05). After treatment,the scores of these factors were significantly decreased in both groups, moreover,which in research group were superior to those in control group(P<0.05). Before treatment there were no significant differences in positive coping dimension scores and negative coping dimension scores between the two groups(P>0.05).After treatment,the scores of positive coping dimension and negative coping dimension of TCSQ rating scales scale were significantly decreased in both groups,moreover,which in research group were superior to those in control group(P<0.05).Before treatment,there were no significant differences in ATQ scores between the two groups(P>0.05).After treatment,the ATQ scores were significantly decreased in both groups,moreover,the decrease degree in research group was more significant than that in control group(P<0.05).In addition the total effective rate in research group was 78.72%,which was significantly higher than that(61.70%) in control group(P<0.05).Conclusion The cognitive behavioral therapy combined with antidepressants can significantly improve the related symptoms of patients with residual symptoms of depression,which is an ideal treatment program and is worthy of clinical promotion.
Objective To investigate the clinical curative effects of cognitive behavioral therapy(CBT) combined with antidepressants on residual symptoms of patients with residual symptoms of depression,so as to provide references for thetreatment of the disease.Methods A total of 94 patients with residual symptoms of depression who were treated in our hospital from July 2013 to June 2017 were enrolled in the study,who were divided into control group and research group according to random digital table.The patients in control group were treated by antidepressant drugs,however,the patients in research group,on the basis of control group,were treated by CBT.After 24-week treatment the depression factor score,anxiety factor score and sleep disorder factor score were observed and compared between the two groups,moreover, the TCSQ scale scores,automatic thinking questionnaire(ATQ) score and treatment efficiency were observed and compared between the two groups.Results Before treatment,there were no significant differences in depression factor scores,anxiety factor scores and sleep disorder factor scores between the two groups(P>0.05). After treatment,the scores of these factors were significantly decreased in both groups, moreover,which in research group were superior to those in control group(P<0.05). Before treatment there were no significant differences in positive coping dimension scores and negative coping dimension scores between the two groups(P>0.05).After treatment,the scores of positive coping dimension and negative coping dimension of TCSQ rating scales scale were significantly decreased in both groups,moreover,which in research group were superior to those in control group(P<0.05).Before treatment,there were no significant differences in ATQ scores between the two groups(P>0.05).After treatment,the ATQ scores were significantly decreased in both groups,moreover,the decrease degree in research group was more significant than that in control group(P<0.05).In addition the total effective rate in research group was 78.72%,which was significantly higher than that(61.70%) in control group(P<0.05).Conclusion The cognitive behavioral therapy combined with antidepressants can significantly improve the related symptoms of patients with residual symptoms of depression,which is an ideal treatment program and is worthy of clinical promotion.
引文
1 李凌江.抑郁症的残留症状与药物治疗.中华精神科杂志,2013,46:375-376.
2 Ogrodniczuka JS,Piperb WE,Joycec AS.Residual symptoms in depressed patients who successfully respond to shortterm psychotherapy.J Affect Disord,2004,82:469-473.
3 刘刚,钟鸣,崔明湖.叙事疗法对双相抑郁症患者生活质量的影响研究.中国医院统计,2018,25:104-106,110.
4 Association AP.Diagnostic and statistical manual of mental disorders.text revision(DSM-IV-TR).4th.Washington DC:American Psychiatric Association,2000.173-179.
5 张菁,周德祥,徐晓燕,等.认知行为治疗对社区抑郁症患者残留症状的影响.精神医学杂志,2015,28:34-36.
6 张明园主编.精神科量表评定手册.第2版.长沙:湖南科学技术出版社,1998.121-126.
7 何小婷,孙宁,杜巧荣,等.抑郁症伴焦虑症状的影响因素分析.中国神经精神疾病杂志,2016,42:206-210.
8 柳艳松,孙倩芸,陈新宇.首发轻中度青年抑郁症患者接受认知行为治疗前后的内隐刻板印象.中国健康心理学杂志,2015,23:1779-1782.
9 王东波,徐松泉,汤庆平,等.抗抑郁药合并认知治疗对社区老年抑郁症患者残留症状的疗效.浙江医学,2013,35:2093-2095,2098.
10 常余善,尤加永,张建,等.文拉法辛联合认知行为治疗青少年抑郁症对照研究.中国健康心理学杂志,2014,22:183-184.
11 赵丽彩,尹训宝,孙宏伟.抑郁症患者抑郁水平、生活质量与自杀风险关系.中国健康心理学杂志,2016,24:983-986.
12 肖乐,丰雷,朱雪泉,等.中国抑郁症患者急性期治疗后残留症状的现况调查.中华精神科杂志,2017,50:175-181.
13 谢姣,高艳斌.认知行为干预对老年抑郁症患者生活质量及病情的影响.中国老年学杂志,2014,34:524-525.
14 李东冬,戴立磊,秦碧勇.认知行为疗法在老年抑郁症患者中的应用效果.海南医学,2017,28:1741-1744.
15 张博元,丁雪凡,卢卫红,等.团体认知行为治疗对轻度抑郁症患者生活质量及社会功能的作用.上海精神医学,2016,28:18-27.
16 任雁娟,林小敏.正念认知疗法在抑郁症患者日常护理中的应用.中国医药导报,2016,13:174-177.
17 徐松泉,蔡进伟,朱桂东,等.认知治疗合并抗抑郁药对抑郁症残留症状的效果.中国康复医学杂志,2010,25:75-77.
18 杨燕,谢育花,叶莉珍.抑郁症残留症状患者的自动思维和应付方式的调查研究.中国现代医药杂志,2015,17:61-63.
2 Ogrodniczuka JS,Piperb WE,Joycec AS.Residual symptoms in depressed patients who successfully respond to shortterm psychotherapy.J Affect Disord,2004,82:469-473.
3 刘刚,钟鸣,崔明湖.叙事疗法对双相抑郁症患者生活质量的影响研究.中国医院统计,2018,25:104-106,110.
4 Association AP.Diagnostic and statistical manual of mental disorders.text revision(DSM-IV-TR).4th.Washington DC:American Psychiatric Association,2000.173-179.
5 张菁,周德祥,徐晓燕,等.认知行为治疗对社区抑郁症患者残留症状的影响.精神医学杂志,2015,28:34-36.
6 张明园主编.精神科量表评定手册.第2版.长沙:湖南科学技术出版社,1998.121-126.
7 何小婷,孙宁,杜巧荣,等.抑郁症伴焦虑症状的影响因素分析.中国神经精神疾病杂志,2016,42:206-210.
8 柳艳松,孙倩芸,陈新宇.首发轻中度青年抑郁症患者接受认知行为治疗前后的内隐刻板印象.中国健康心理学杂志,2015,23:1779-1782.
9 王东波,徐松泉,汤庆平,等.抗抑郁药合并认知治疗对社区老年抑郁症患者残留症状的疗效.浙江医学,2013,35:2093-2095,2098.
10 常余善,尤加永,张建,等.文拉法辛联合认知行为治疗青少年抑郁症对照研究.中国健康心理学杂志,2014,22:183-184.
11 赵丽彩,尹训宝,孙宏伟.抑郁症患者抑郁水平、生活质量与自杀风险关系.中国健康心理学杂志,2016,24:983-986.
12 肖乐,丰雷,朱雪泉,等.中国抑郁症患者急性期治疗后残留症状的现况调查.中华精神科杂志,2017,50:175-181.
13 谢姣,高艳斌.认知行为干预对老年抑郁症患者生活质量及病情的影响.中国老年学杂志,2014,34:524-525.
14 李东冬,戴立磊,秦碧勇.认知行为疗法在老年抑郁症患者中的应用效果.海南医学,2017,28:1741-1744.
15 张博元,丁雪凡,卢卫红,等.团体认知行为治疗对轻度抑郁症患者生活质量及社会功能的作用.上海精神医学,2016,28:18-27.
16 任雁娟,林小敏.正念认知疗法在抑郁症患者日常护理中的应用.中国医药导报,2016,13:174-177.
17 徐松泉,蔡进伟,朱桂东,等.认知治疗合并抗抑郁药对抑郁症残留症状的效果.中国康复医学杂志,2010,25:75-77.
18 杨燕,谢育花,叶莉珍.抑郁症残留症状患者的自动思维和应付方式的调查研究.中国现代医药杂志,2015,17:61-63.