强迫症认知行为治疗技术的适宜性评估  

Suitability study on techniques of cognitive behavioral therapy for obsessive-compulsive disorder

作　　者：黄芳芳[1] 李占江[1] 郭萌[1] 韩海英[1] 

机构地区：[1]首都医科大学附属北京安定医院,北京100088

出　　处：《中华行为医学与脑科学杂志》2013年第11期998-1000,共3页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：基金项目：国家科技支撑计划（2009BA177811）

摘　　要：目的对强迫症（Obsessive-compulsivedisorder，OCD）的认知行为治疗（CognitiveBehavioralTherapy，CBT）技术进行适宜性评估，分析CBT技术在国内的应用现状，为制定OCD的CBT技术手册和规范化治疗奠定基础。方法通过Delphi法从可操作性、使用频率、治疗效果贡献和患者接受程度4个维度对30个CBT技术进行评估，计算各技术各维度的最终得分及综合秩次。结果通过两轮专家咨询，计算4个维度肯德尔系数为0．249、0．269、0．234、0．250（P〈0．01），专家评估各技术各维度变异系数范围为0．05～0．31。适宜性评估结果显示思维阻止、成本效益分析和饼图法的可操作性属于一般适宜；思维阻止和饼图法的使用频率和治疗效果贡献属于偶尔使用和效果小；苏格拉底提问、思维阻止、现场暴露和行为阻止的患者接受程度属于部分接受。4个维度权重系数为0．26、0．18、0．27和0．29，综合秩次排名前三位的是资料收集与评估、建立治疗联盟、心理教育。结论对于OCD的治疗大部分CBT技术国内应用适宜性好，部分技术仍需完善。Objective To evaluate the suitability of cognitive behavioral therapy （CBT） techniques for obsessive-compulsive disorder （ OCD）, and analyze the domestic application status of CBT techniques for OCD and lay a foundation of standard CBT in China. Methods Delphi method was adopted to evaluate 30 CBT techniques on four dimensions, including operability, frequency, contribution of treatment and acceptability, and calculated the final scores of all techniques on different dimension and their comprehensive rank. Results After two rounds of experts consulting, Kendall coefficients of four dimensions were 0.249,0.269,0.234,0.250 （P〈 0.01 ）, coefficient of variation ranged from 0.05 to 0.31 of each technology on different dimension. The operability score of thought stop- ping, cost-benefit analysis and pie chart belonged to general suitability. The frequency and treatment contribution score of thought stopping and pie chart belonged to occasional use and small.The acceptation score of socratic ques- tion, thought stopping,in vivo exposure and behavior prevention belonged to partial acceptation. Weight coefficients of four dimensions were 0.26,0.18,0.27,0.29 and techniques ranking in the top three were information collection and evaluation,therapeutic alliance foundation and psychological education. Conclusion Most CBT techniques for OCD are suitable in China but some techniques still need to be improved.

关 键 词：强迫症 认知行为治疗 DELPHI法 

分 类 号：R749.7[医药卫生—神经病学与精神病学]