微信心理干预对惊恐障碍患者的辅助治疗研究  

Study on Effect of Wechat Psychological Intervention on Adjunctive Therapy of Patients with Panic Disorder

作　　者：赵永忠[1] 杨闯[1] 林子江[1] 王维千[1] 易艳红[1] 

机构地区：[1]温州医科大学附属第一医院

出　　处：《医院管理论坛》2016年第8期39-42,共4页Hospital Management Forum

基　　金：浙江省自然科学基金项目;编号:LY14H090012

摘　　要：目的探讨基于微信的网络团体心理辅导时对惊恐障碍患者的辅助治疗作用。方法筛选精神科门诊符合《美国精神疾病诊断和统计手册第4版》中伴或不伴有场所恐怖的惊恐障碍诊断标准,并有微信使用习惯的患者84例,随机分为两组。共81人完成试验,其中微信组(n=42)在抗抑郁药物艾司西酞普兰治疗同时予以微信团体心理辅导,对照组(n=39)予以同样药物治疗同时通过微信定期随访。比较两组治疗前后惊恐障碍严重度量表(PDSS)、汉密尔顿焦虑量表(HAMA)评分,惊恐障碍痊愈率,以及服药依从性。结果两组治疗前后PDSS各因子分和总分进行重复测量方差分析,时间效应均有统计学意义(P<0.001),微信组和对照组治疗4周时发作时痛苦感(0.92±0.73vs.1.33±0.73)和预期性焦虑(0.94±0.71vs.1.38±0.80)两个因子分及总分(5.83±4.40vs.7.10±4.35)差异有统计学意义(P<0.05)。微信组与对照组HAMA评分在治疗前差异无统计学意义,而治疗1周、2周、4周及8周差异均有统计学意义(P<0.05)。微信组与对照组的痊愈率分别为66.7%、51.3%(P=0.159),服药依从性好的比例为96.5%、71.8%(P=0.031)。结论在惊恐障碍的药物治疗早期,联合微信团体心理辅导,可以快速缓解焦虑症状,提高治疗依从性。Objective Discussion on the Adjurant Therapy Effect of Wechat Network Group Counseling on Paatients with Panic Disorder. Methods In total of 84 patients with panic disorder（PD）（with or without agoraphobia） meeting the diagnostic criteria of PD from The Diagnostic and Statistical Manual of Mental Disorders fourth edition（DSM-Ⅳ） and habit of using Wechat were included in this study and were divided into two groups. There were 81 patients finishing this study. Patients in Wechat group（n=42） received Escitalopram treatment combined with Wechat group guidance, and patients in control group（n=39） received same drug treatment combined with regular follow-up through Wechat. Scores of Panic Disorder Severity Scale（PDSS） and Hamilton Anxiety Rating Scale（HAMA）, recovery rate of PD and good adherence rate before and after the treatment in the two groups were compared. Results Repeated measures analysis of variance was adopted to analyze factor score and total score before and after the treatment, and the results showed the time effect was statistically significant（P〈0.001）. After 4-week treatment, the differences of pain scores（0.92±0.73 vs. 1.33±0.73）, anticipatory anxiety score（0.94±0.71 vs. 1.38±0.80） and total scores（5.83±4.40 vs. 7.10±4.35） of Wechat group and Control group were statistically significant（P〈0.05）. Before treatment, there was no statistically significant differences of HAMA scores in Wechat group and control group. However, there were significant differences at week 1, 2, 4 and 8 after treatment（P〈0.05）. The recovery rate of PD in Wechat group and control group was 66.7% and 51.3% respectively（P=0.159） and good adherence rate in Wechat group and control group was 96.5% and 71.8% respectively（P=0.031）. Conclusion Short term Wechat group psychology guidance can effectively alleviate anxiety and improve adherence in early treatment period of PD.

关 键 词：惊恐障碍 团体辅导 药物治疗 

分 类 号：R749.3[医药卫生—神经病学与精神病学]