认知行为疗法和帕罗西汀治疗对轻型抑郁障碍的临床对照研究  

A Comparative Study of Cognitive-Behavior Therapy and Paroxetine for Minor Depression

作　　者：桑文华[1] 张迪然 田国庆[1] 于雪竹[1] 刘建丛[1] 杨老虎[1] 张彦恒[1] 

机构地区：[1]河北省第六人民医院河北省精神卫生中心,保定071000 [2]贵州省第二人民医院,贵阳550004

出　　处：《中国循证医学杂志》2007年第10期711-714,共4页Chinese Journal of Evidence-based Medicine

摘　　要：目的比较认知行为疗法和帕罗西汀对轻型抑郁障碍患者的临床疗效及预后差异。方法制定一套适用于轻型抑郁障碍的认知行为治疗操作手册。将64例符合DSM-Ⅳ诊断标准的轻型抑郁障碍患者分为认知行为治疗组和帕罗汀治疗组各32例,治疗6周,用汉密顿抑郁量表评定两组治疗前和治疗后第2、4、6周末的减分值、6周后疗效及6个月随访时的复发/再燃率及其副作用。结果①治疗有第6周末两组减分值差异有统计学意义(F=8.3,P=0);②帕罗汀治疗组和认知行为治疗组在第6周末两组疗效差异无统计学意义(u=316.5,P=0.06),其中帕罗汀治疗组痊愈率为20.7%,显效率为48.3%,认知行为治疗组痊愈率为10.0%,显效率为36.7%。③随访时6个月时,帕罗汀组复发(包括再燃率)高于认知行为治疗组(u=106.5,P=0.04)。结论单纯认知行为治疗与帕罗汀治疗在一定程度上疗效相当,所制定的手册针对轻型抑郁障碍患者的特点,对于轻型抑郁障碍有一定的治疗效果,可在临床推广试用。Objective To compare the effects of cognitive-behavior therapy （CBT） and domesticparoxetine in the treatment of minor depression. Methods A therapeutic technique model for the treatment of minor depression was established. Sixty-four patients with minor depression meeting DSM-Ⅳ criteria were divided into CBT and paroxetine groups with 32 patients respectively, and were treated for six weeks. The Hamilton Depression Scale （HAMD） was used to evaluate the clinical efficacy and relapse/recrudescence rate of the two groups. Side effects of paroxetine were also recorded. Results At the end of 2 weeks,no significant difference was noted in the reduction of the HAMD score between the two groups. At the end of 6 weeks,there was little difference in the HAMD score reduction between the two groups （F=8.3,P= 0）. No significant difference was found in the curative effects between the two groups （u=316.5,P=0.06）.In the paroxetine group,cure rate was 20.7%, significant improvement rate was 48.3%; In the CBT group, cure rate was 10.0%,significant improvement rate was 36.7%.The relapse/recrudescence rate after six in the paroxetine group was higher than in cognitive-behavior therapy group at 6 months＇ followup （u=106.5,P=0.04）.Conclusion The clinical efficacy of cognitive-behavior therapy for minor depression seems to be similar to that of paroxetine. The established model of CBT can be used in clinical practice.

关 键 词：心理学 认知行为疗法 帕罗西汀 抑郁障碍 临床对照研究 

分 类 号：R749.4[医药卫生—神经病学与精神病学]