60例青少年强迫症患者服用盐酸帕罗西汀联合心理干预的效果研究
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摘要
目的:探讨盐酸帕罗西汀联合心理干预在青少年强迫症患者中应用效果。方法:选取我院119例青少年强迫症患者,按照随机双盲法分组,对照组59例采用盐酸帕罗西汀治疗,观察组60例于对照组基础上实施心理干预,观察比较两组干预前后耶鲁-布朗强迫量表(Y-BOCS)评分及干预效果,并统计两组患者满意度及生活质量。结果:干预3个月后观察组强迫行为因子评分、强迫思维因子评分及Y-BOCS总分低于对照组,差异具有统计学意义(t=-2.753,-3.361,-4.382;P<0.01);观察组干预总有效率为88.33%(53/60),高于对照组61.02%(36/59),差异具有统计学意义(χ~2=11.773,P<0.001);观察组患者满意度为91.67%(55/60),高于对照组69.49%(41/59),差异具有统计学意义(χ~2=9.382,P<0.01);观察组干预3个月后生理功能、情感精神、社会功能及躯体功能各维度生活质量评分高于对照组,差异具有统计学意义(t=6.841,5.731,6.133,6.662;P<0.01)。结论:心理干预联合盐酸帕罗西汀有助于改善青少年强迫症状及生活质量,效果显著,患者满意度高。
Objective:To investigate the application effect of paroxetine hydrochloride combined with psychological intervention in adolescents with obsessive-compulsive disorder.Methods:A total of 119 cases of adolescents with obsessive-compulsive disorder in our hospital were randomly divided into two groups.The control group of 59 cases was treated by paroxetine hydrochloride,and 60 cases in the observation group were given psychological intervention on the basis of the control group.The Yale Brown's Compulsive Scale(Y-BOCS)score and the effect of intervention of two groups before and after intervention were observed and compared.The patients' satisfaction and quality of life two of groups were recorded.Results:After 3 months of intervention,the score of compulsive behavior factor,the score of forced thinking factor and the total score of Y-BOCS of the observation group were lower than those of the control group.The differences were statistically significant(t=-2.753,-3.361,-4.382;P<0.01).The total effective rate of intervention of the observation group was 88.33%(53/60),which was higher than that of the control group[61.02%(36/59)](χ~2=11.773,P<0.001).The patients' satisfaction of the observation group was 91.67%(55/60),which was higher than that of the control group[69.49%(41/59)],and the difference was statistically significant(χ~2=9.382,P<0.01).After 3 months of intervention,the scores of life quality in all dimensions of physiological function,emotional and social function and physical function were significantly higher in the observation group than in the control group,and the differences were statistically significant(t=6.841,5.731,6.133,6.662;P<0.01).Conclusion:Psychological intervention combined with paroxetine hydrochloride can help to improve the compulsive symptoms and quality of life of adolescents with obsessive-compulsive disorder.The effect is significant and the patient's satisfaction is high.
Objective:To investigate the application effect of paroxetine hydrochloride combined with psychological intervention in adolescents with obsessive-compulsive disorder.Methods:A total of 119 cases of adolescents with obsessive-compulsive disorder in our hospital were randomly divided into two groups.The control group of 59 cases was treated by paroxetine hydrochloride,and 60 cases in the observation group were given psychological intervention on the basis of the control group.The Yale Brown's Compulsive Scale(Y-BOCS)score and the effect of intervention of two groups before and after intervention were observed and compared.The patients' satisfaction and quality of life two of groups were recorded.Results:After 3 months of intervention,the score of compulsive behavior factor,the score of forced thinking factor and the total score of Y-BOCS of the observation group were lower than those of the control group.The differences were statistically significant(t=-2.753,-3.361,-4.382;P<0.01).The total effective rate of intervention of the observation group was 88.33%(53/60),which was higher than that of the control group[61.02%(36/59)](χ~2=11.773,P<0.001).The patients' satisfaction of the observation group was 91.67%(55/60),which was higher than that of the control group[69.49%(41/59)],and the difference was statistically significant(χ~2=9.382,P<0.01).After 3 months of intervention,the scores of life quality in all dimensions of physiological function,emotional and social function and physical function were significantly higher in the observation group than in the control group,and the differences were statistically significant(t=6.841,5.731,6.133,6.662;P<0.01).Conclusion:Psychological intervention combined with paroxetine hydrochloride can help to improve the compulsive symptoms and quality of life of adolescents with obsessive-compulsive disorder.The effect is significant and the patient's satisfaction is high.
引文
[1]东振明,孙芳,刘兴华.正念体悟疗法干预9例强迫症效果报告[J].中国健康心理学杂志,2016,24(1):17-22
[2]Vaghi M M,Vértes P E,Kitzbichler M G,et al.Specific frontostriatal circuits for impaired cognitive flexibility and goal-directed planning in obsessive-compulsive disorder:Evidence from resting-state functional connectivity[J].Biol Psychiatry,2017,81(8):708-717
[3]李峥,王体宾,孔德荣.结构式家庭疗法联合舍曲林对首发青少年强迫症的疗效[J].中国健康心理学杂志,2015,23(9):1293-1296
[4]Baldwin D S,Anderson I M,Nutt D J,et al.Evidence-based pharmacological treatment of anxiety disorders,post-traumatic stress disorder and obsessive-compulsive disorder:A revision of the 2005guidelines from the British Association for Psychopharmacology[J].J Psychopharmacol,2014,28(5):403-439
[5]吴海苏,肖泽萍.谷氨酸系统在强迫症发病机制中的作用[J].中华精神科杂志,2013,46(5):314-317
[6]赵鸿飞,罗辉兰,冯珍珍,等.盐酸帕罗西汀治疗帕金森合并抑郁和焦虑患者的疗效及安全性[J].国际精神病学杂志,2017,44(3):480-482
[7]刘耀中,张珺,窦凯,等.重复经颅磁刺激治疗强迫症的研究进展[J].暨南大学学报(自然科学与医学版),2014,35(2):136-141
[8]丁宝艳.综合心理护理干预治疗强迫症患者临床效果分析[J].中外医疗,2015,34(24):160-162
[9]张慧芳,郭华,张燕,等.心理干预疗法对强迫症患者的疗效分析[J].国际精神病学杂志,2017,44(1):136-138
[10]孔令军,刘诏薄,左小云,等.帕罗西汀合并奥氮平治疗强迫症的疗效与安全性[J].中国医学创新,2015,12(27):40-42
[11]张力方,牛琪惠,杨磊,等.舍曲林联用丁螺环酮和单用舍曲林治疗强迫症的疗效比较[J].中国新药与临床杂志,2015,34(3):236-238
[12]Frendl D M,Ware Jr J E.Patient-reported functional health and well-being outcomes with drug therapy:A systematic review of randomized trials using the SF-36health survey[J].Medical Care,2014,52(5):439-445
[13]温全胜,张传福,卢文芬,等.帕罗西汀治疗强迫症患者的疗效观察[J].中国药物经济学,2015,10(8):38-39
[14]黄荣,陈文武.盐酸帕罗西汀对神经症患者认知功能及预后的改善作用观察[J].医药论坛杂志,2017,38(5):13-15
[15]朱立毛,舒菊红,戴升太.帕罗西汀合并不同剂量阿立哌唑治疗强迫症的临床观察[J].临床精神医学杂志,2014,24(2):115-117
[16]黄生万.盐酸帕罗西汀合并奥氮平治疗强迫症的效果分析[J].中国当代医药,2016,23(24):43-45
[17]赵毅基,伍少娟.行为矫治与心理干预对强迫症患者康复效果的影响[J].中国医药科学,2016,6(22):131-133+165
[18]邱松伟,樊素琴,付慧鹏,等.药物及心理干预对强迫症心率变异的影响[J].中国实用神经疾病杂志,2015,18(20):83-84
[19]Romanelli R J,Wu F M,Gamba R,et al.Behavioral therapy and serotonin reuptake inhibitor pharmacotherapy in the treatment of obsessive-compulsive disorder:A systematic review and meta‐analysis of head‐to‐head randomized controlled trials[J].Depress Anxiety,2014,31(8):641-652
[20]连楠,李幼辉,宋学勤,等.强迫症患者行团体心理治疗的效果观察[J].山东医药,2013,53(7):59-61
[21]程洪燕.强迫症的心理治疗研究进展[J].山东医药,2015,55(23):96-98
[2]Vaghi M M,Vértes P E,Kitzbichler M G,et al.Specific frontostriatal circuits for impaired cognitive flexibility and goal-directed planning in obsessive-compulsive disorder:Evidence from resting-state functional connectivity[J].Biol Psychiatry,2017,81(8):708-717
[3]李峥,王体宾,孔德荣.结构式家庭疗法联合舍曲林对首发青少年强迫症的疗效[J].中国健康心理学杂志,2015,23(9):1293-1296
[4]Baldwin D S,Anderson I M,Nutt D J,et al.Evidence-based pharmacological treatment of anxiety disorders,post-traumatic stress disorder and obsessive-compulsive disorder:A revision of the 2005guidelines from the British Association for Psychopharmacology[J].J Psychopharmacol,2014,28(5):403-439
[5]吴海苏,肖泽萍.谷氨酸系统在强迫症发病机制中的作用[J].中华精神科杂志,2013,46(5):314-317
[6]赵鸿飞,罗辉兰,冯珍珍,等.盐酸帕罗西汀治疗帕金森合并抑郁和焦虑患者的疗效及安全性[J].国际精神病学杂志,2017,44(3):480-482
[7]刘耀中,张珺,窦凯,等.重复经颅磁刺激治疗强迫症的研究进展[J].暨南大学学报(自然科学与医学版),2014,35(2):136-141
[8]丁宝艳.综合心理护理干预治疗强迫症患者临床效果分析[J].中外医疗,2015,34(24):160-162
[9]张慧芳,郭华,张燕,等.心理干预疗法对强迫症患者的疗效分析[J].国际精神病学杂志,2017,44(1):136-138
[10]孔令军,刘诏薄,左小云,等.帕罗西汀合并奥氮平治疗强迫症的疗效与安全性[J].中国医学创新,2015,12(27):40-42
[11]张力方,牛琪惠,杨磊,等.舍曲林联用丁螺环酮和单用舍曲林治疗强迫症的疗效比较[J].中国新药与临床杂志,2015,34(3):236-238
[12]Frendl D M,Ware Jr J E.Patient-reported functional health and well-being outcomes with drug therapy:A systematic review of randomized trials using the SF-36health survey[J].Medical Care,2014,52(5):439-445
[13]温全胜,张传福,卢文芬,等.帕罗西汀治疗强迫症患者的疗效观察[J].中国药物经济学,2015,10(8):38-39
[14]黄荣,陈文武.盐酸帕罗西汀对神经症患者认知功能及预后的改善作用观察[J].医药论坛杂志,2017,38(5):13-15
[15]朱立毛,舒菊红,戴升太.帕罗西汀合并不同剂量阿立哌唑治疗强迫症的临床观察[J].临床精神医学杂志,2014,24(2):115-117
[16]黄生万.盐酸帕罗西汀合并奥氮平治疗强迫症的效果分析[J].中国当代医药,2016,23(24):43-45
[17]赵毅基,伍少娟.行为矫治与心理干预对强迫症患者康复效果的影响[J].中国医药科学,2016,6(22):131-133+165
[18]邱松伟,樊素琴,付慧鹏,等.药物及心理干预对强迫症心率变异的影响[J].中国实用神经疾病杂志,2015,18(20):83-84
[19]Romanelli R J,Wu F M,Gamba R,et al.Behavioral therapy and serotonin reuptake inhibitor pharmacotherapy in the treatment of obsessive-compulsive disorder:A systematic review and meta‐analysis of head‐to‐head randomized controlled trials[J].Depress Anxiety,2014,31(8):641-652
[20]连楠,李幼辉,宋学勤,等.强迫症患者行团体心理治疗的效果观察[J].山东医药,2013,53(7):59-61
[21]程洪燕.强迫症的心理治疗研究进展[J].山东医药,2015,55(23):96-98