认知行为治疗对抑郁症患者疾病认知、心理健康水平及应对方式的影响
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摘要
目的研究认知行为治疗(cognitive behavior therapy,CBT)对抑郁症患者疾病认知、心理健康水平及应对方式的影响。方法连续选择2016年6月～2017年6月入我院诊断为抑郁症患者共96例,随机将其分为对照组和观察组,各48例。对照组采用常规专科护理,观察组采用CBT;采用生存质量简表(WHOQOL)比较两组患者治疗后疾病认知程度,汉密尔顿抑郁量表(HAMD)比较心理健康水平,简易应对方式问卷(simple coping style questionnaire,SCSQ)比较应对方式。结果观察组治疗后WHOQOL中生理领域、心理领域、社会关系和环境领域4个项目评分和总评分均显著高于对照组,差异有统计学意义(P<0.05)。观察组HAMD评分显著低于对照组,可能抑郁和无抑郁人群比例明显升高,差异有统计学意义(P<0.05)。观察组SCSQ积极应对评分显著升高,消极应对评分降低,差异有统计学意义(P<0.05)。结论 CBT可显著改善抑郁症患者的疾病认知、心理健康水平及应对方式。
Objective To study the effect of cognitive behavior therapy(CBT) on the cognition of disease, mental health and coping style in patients with depression. Methods 96 patients with depression diagnosed in our hospital from June2016 to June 2017 were consecutively selected and randomly divided into control group and observation group, with 48 cases in each group. The control group was treated with routine specialist care and the observation group was treated with CBT. The WHOQOL was used to compare the cognitive status, the Hamilton Depression Rating Scale(HAMD) and the level of mental health of the patients after treatment. The simple coping style questionnaire(SCSQ) was used to compare the coping style. Results The scores of the four items including physiological field, psychological field, social relationship and environmental fieldand the total scores of the WHOQOL in the observation group were significantly higher than those in the control group. The difference was statistically significant(P<0.05). The HAMD score in the observation group was significantly lower than that in the control group, and the proportion of possible depression and non-depression populations was significantly higher, with a statistically significant difference(P<0.05). In the observation group, the positive response score of SCSQ increased significantly, and the negative response score decreased. The difference was statistically significant(P<0.05). Conclusion CBT can significantly improve the cognition of disease, mental health and coping style in patients with depression.
Objective To study the effect of cognitive behavior therapy(CBT) on the cognition of disease, mental health and coping style in patients with depression. Methods 96 patients with depression diagnosed in our hospital from June2016 to June 2017 were consecutively selected and randomly divided into control group and observation group, with 48 cases in each group. The control group was treated with routine specialist care and the observation group was treated with CBT. The WHOQOL was used to compare the cognitive status, the Hamilton Depression Rating Scale(HAMD) and the level of mental health of the patients after treatment. The simple coping style questionnaire(SCSQ) was used to compare the coping style. Results The scores of the four items including physiological field, psychological field, social relationship and environmental fieldand the total scores of the WHOQOL in the observation group were significantly higher than those in the control group. The difference was statistically significant(P<0.05). The HAMD score in the observation group was significantly lower than that in the control group, and the proportion of possible depression and non-depression populations was significantly higher, with a statistically significant difference(P<0.05). In the observation group, the positive response score of SCSQ increased significantly, and the negative response score decreased. The difference was statistically significant(P<0.05). Conclusion CBT can significantly improve the cognition of disease, mental health and coping style in patients with depression.
引文
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[14]康燕.支持性心理治疗对复发老年抑郁症患者抑郁症状、生活质量的影响[J].中国老年学,2017,37(18):4654-4656.
[15]曾龙武,唐漫漫,唐晓鸿,等.认知行为干预对肠癌化疗病人照顾者照顾负担的影响[J].中国健康心理学杂志,2017,25(1):43-47.
[16]王霞,杨敏.基于认知行为疗法的自助干预在抑郁患者中的应用[J].中华行为医学与脑科学杂志,2016,25(5):404-409.
[17]贾悦,仇晓溪,魏萍.团体认知行为疗法对直肠癌永久性结肠造口病人心理及自我管理效能感的影响[J].护理研究,2015,(33):4214-4216.
[18]王礼军,郭本禹,张磊.认知行为心理治疗分析系统及其在慢性抑郁症中的应用[J].中国临床心理学杂志,2016,24(4):766-770.
[19]张杰.抑郁症与中医五态人格、负性自动思维及特质应对方式相关研究[D].新乡医学院,2017.
[20]吴耀,张春锋,林妙略,等.抑郁症患者行非指导性音乐治疗对情绪及自动思维的影响[J].国际精神病学杂志,2017,44(2):236-239.
[21]叶百维,邱大宏,刘月霞,等.认知行为疗法结合心理社会支持治疗对抑郁症临床效果的影响[J].中国医药科学,2017,7(15):168-170.
[22]林宏.氟西汀联合行为认知疗法对脑卒中后抑郁症患者总体康复的影响[J].当代医学,2017,(2):115-116.
[23]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[J].中国医药导报,2016,13(34):174-177.
[2]Kim SW,Jang JE,Lee JY,et al.Effects of group cognitive-behavioral therapy in young patients in the early stage of psychosis[J].Psychiatry Investig,2017,14(5):609-617.
[3]禹婷婷,徐丹,朱咏娜,等.认知行为干预对抑郁症患者负性情绪和服药依从性的影响[J].中国医学创新,2017,14(7):138-141.
[4]蒋菊芳,许玉芳,丁兰芬,等.认知行为干预对抑郁症病人应对方式和生存质量的影响[J].护理研究,2013,27(11):3608-3610.
[5]中华医学会精神科分会.中国精神障碍分类与诊断标准[M].第3版.济南:山东科学技术出版社,2001:87-89.
[6]李江婵,姚素华,谢秀东,等.认知行为治疗对抑郁症患者病耻感和应对方式的影响研究[J].中国全科医学,2015,18(4):463-465.
[7]郑旻欣.认知行为治疗对抑郁症患者病耻感和应对方式的影响研究[J].大医生,2017,2(7):184,186.
[8]李桂林,陈炯华,张玉琦,等.认知行为干预对抑郁症患者自杀意念的影响[J].中华护理杂志,2014,49(10):1202-1206.
[9]奚耕思,张武会.抑郁症发生机制研究进展[J].陕西师范大学学报(自然科学版),2011,39(6):64-71.
[10]Norlund F,Olsson EM,Burell G.Treatment of depression and anxiety with internet-based cognitive behavior therapy in patients with a recent myocardial in farction(U-CARE Heart):Study protocol for a randomized controlled trial[J].Trials,2015,16(4):154.
[11]Eells TD,Barrett MS,Wright JH.Computer-assisted cognitive-behavior therapy for depression[J].Psychotherapy(Chic),2014,51(2):191-197.
[12]Vallury KD,Jones M,Oosterbroek C.Computerized Cognitive Behavior Therapy for Anxiety and Depression in Rural Areas:A Systematic Review[J].J Med Internet Res,2015,17(6):e139.
[13]Handley TE,Kay-Lambkin FJ,Baker AL,et al.Incidental treatment effects of CBT on suicidal ideation and hopelessness[J].Affect Disord,2013,327(13):481-483.
[14]康燕.支持性心理治疗对复发老年抑郁症患者抑郁症状、生活质量的影响[J].中国老年学,2017,37(18):4654-4656.
[15]曾龙武,唐漫漫,唐晓鸿,等.认知行为干预对肠癌化疗病人照顾者照顾负担的影响[J].中国健康心理学杂志,2017,25(1):43-47.
[16]王霞,杨敏.基于认知行为疗法的自助干预在抑郁患者中的应用[J].中华行为医学与脑科学杂志,2016,25(5):404-409.
[17]贾悦,仇晓溪,魏萍.团体认知行为疗法对直肠癌永久性结肠造口病人心理及自我管理效能感的影响[J].护理研究,2015,(33):4214-4216.
[18]王礼军,郭本禹,张磊.认知行为心理治疗分析系统及其在慢性抑郁症中的应用[J].中国临床心理学杂志,2016,24(4):766-770.
[19]张杰.抑郁症与中医五态人格、负性自动思维及特质应对方式相关研究[D].新乡医学院,2017.
[20]吴耀,张春锋,林妙略,等.抑郁症患者行非指导性音乐治疗对情绪及自动思维的影响[J].国际精神病学杂志,2017,44(2):236-239.
[21]叶百维,邱大宏,刘月霞,等.认知行为疗法结合心理社会支持治疗对抑郁症临床效果的影响[J].中国医药科学,2017,7(15):168-170.
[22]林宏.氟西汀联合行为认知疗法对脑卒中后抑郁症患者总体康复的影响[J].当代医学,2017,(2):115-116.
[23]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[J].中国医药导报,2016,13(34):174-177.