认知治疗联合帕罗西汀对首发轻中度抑郁症患者沉思的干预  

Cognitive therapy combined with paroxetine intervention for the rumination of patients with mild to moderate first- episode depression

作　　者：沙东想 孙玉军[1] 徐建龙[1] 苑光宗[1] 周薇[1] 

机构地区：[1]江苏省昆山市第三人民医院,江苏昆山215311

出　　处：《四川精神卫生》2016年第4期315-318,共4页Sichuan Mental Health

摘　　要：目的探讨首发轻中度抑郁症患者接受认知治疗联合帕罗西汀治疗前后沉思的变化。方法将70例符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)诊断标准的首发轻中度抑郁症患者,采用随机抽签法分为实验组和对照组各35例,实验组接受认知治疗联合帕罗西汀治疗,对照组接受帕罗西汀治疗与一般支持心理治疗,观察12周,于治疗前后对所有患者进行沉思反应量表(RRS)测验和汉密尔顿抑郁量表24项版(HAMD-24)评定。结果 1治疗后,实验组HAMD-24总评分、RRS总评分及各分量表评分与治疗前比较差异均有统计学意义(P均<0.05);2治疗后,两组的强迫性冥想分量表评分差异有统计学意义(t=2.28,P=0.02),HAMD-24总评分、RRS总评分、与抑郁相关和反思分量表评分差异均无统计学意义(P均>0.05)。结论认知治疗联合帕罗西汀治疗对缓解轻中度抑郁症患者强迫性冥想的疗效可能较一般支持心理治疗联合帕罗西汀更好。Objective To investigate the change of rumination of patients with mild to moderate first- episode depression before and after cognitive therapy combined with paroxetine. Methods 70 mild to moderate first- episode depression patients who met the criterion of Diagnostic and Statistical Manual of Mental Disorders,fourth edition( DSM- IV) were assigned to the experimental group and the control group with simple randomization method,and 35 cases in each group. The experimental group received cognitive therapy combined with paroxetine for 12 weeks. The control group received supportive psychotherapy combined with paroxetine for12 weeks. Before and after treatment,all the participants completed the Rumination Response Scale( RRS) and Hamilton Depression Scale- 24 item( HAMD- 24) respectively. Results 1 In the experimental group,the total scores of HAMD,RRSand three subfactors( Depression related,Brooding,Reflection) of RRS were higher at the end of treatment than those before treatment( P < 0. 05).2At the end of the 12 thweek,the Brooding score was lower in the experimental group than that in the control group( t = 2. 28,P = 0. 02),but there was no significant difference in the scores of HAMD- 24,RRS and the other two subfactors( Depression related,Reflection)of RRS. Conclusion Cognitive therapy combined with paroxetine may be more effective than supportive psychotherapy combined with paroxetine on the Brooding of RRS for mild to moderate first- episode depression patients.

关 键 词：抑郁症 沉思 强迫性冥想 认知治疗 

分 类 号：R749.4[医药卫生—神经病学与精神病学]