抑郁症整体管理模式近期效果评价  

Efficacy of integrated-model management on chronic depression

作　　者：汪作为[1,2] 方芳[2] 陆志萍[2] 王萍[2] 陈银娣[2] 张少平[2] 方贻儒[1] 

机构地区：[1]上海交通大学医学院附属精神卫生中心心境障碍科,上海200030 [2]上海市虹口区精神卫生中心,上海200083

出　　处：《上海交通大学学报（医学版）》2010年第6期639-642,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家高技术研究发展计划("863"计划)(2006AA02Z430);上海市公共卫生优秀青年人才培养计划(08GWQ030);上海市卫生局青年科研课题(2008Y056);上海市虹口区医学科研课题(虹卫0801-03)~~

摘　　要：目的评价整体管理模式对慢性抑郁症患者的近期效果。方法非急性发作期且汉密尔顿抑郁量表(HAMD-17)≥3分的门诊抑郁症患者开放式进入管理组(n=30)和对照组(n=30)。管理组患者在常规门诊治疗基础上接受团体心理干预、自助团体和自我管理的整体管理;对照组继续门诊常规治疗。主要结局评估HAMD-17评分从基线至终点(第6个月末)的变化;次要结局评估包括临床痊愈率、复发率和社会功能缺陷筛选表(SDSS)评分变化。结果协方差分析(ANCOVA)显示管理组与对照组之间基线至终点HAMD-17和SDSS的评分变化差异均有统计学意义(F=46.80,P=0.00;F=49.29,P=0.00);但F isher s精确检验显示,两组临床痊愈率和复发率比较,差异均无统计学意义(P>0.05)。结论整体管理模式可能改善慢性抑郁症患者的残留症状和社会功能。Objective To evaluate the short-term efficacy of integrated-model management on chronic depression.MethodsOutpatients with depression and Hamilton Rating Scale for Depression-17（HAMD-17）≥3 and without acute episode openly entered management group（n=30） and control group（n=30）.Patients in management group received regular clinical care,group therapy intervention,self-help group and self-management,while those in control group only received regular clinical care.The primary outcomes was changes of HAMD-17 scores from baseline to endpoint（the end of the sixth month）,and the secondary outcomes included remission rate,recurrence rate and changes of Social Disability Screening Schedule（SDSS） scores from baseline to endpoint.ResultsAnalysis of covariance（ANCOVA） revealed that there were significant differences in the changes of HAMD-17 scores and SDSS scores from baseline to endpoint between management group and control group（F=46.80,P=0.00;F=49.29,P=0.00）.However,Fisher＇s exact test indicated that there was no significant difference in the rates of remission and recurrence between management group and control group（P0.05）.ConclusionThe integrated-model management may significantly relieve residual symptoms and improve social function of patients with chronic depression.

关 键 词：抑郁症 残留症状 痊愈 自我管理 整体模式 

分 类 号：R749.4[医药卫生—神经病学与精神病学]