轻症抑郁结构式团体认知行为治疗手册的编制与可行性分析  

Establishment and feasibility analysis of structural Cognitive Behavioral Group Therapy manual in patients with mild depression

作　　者：孙霞 苑成梅[1] 王宇[1] 卢卫红 陈涵 叶尘宇[2] 陈华[2] 薛莉莉 宋蕊[3] 方贻儒[1] SUN Xia YUAN Cheng-mei WANG Yu et al(Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, Chin)

机构地区：[1]上海交通大学医学院附属精神卫生中心,200030 [2]复旦大学附属中山医院心理科 [3]上海市虹口区精神卫生中心

出　　处：《神经疾病与精神卫生》2016年第5期517-521,共5页Journal of Neuroscience and Mental Health

基　　金：上海交通大学“医工交叉研究基金”面上项目（YG2011MS37）;上海市卫生局公共卫生海外留学人才项目（GWHW201202）;上海市科委医学引导项目（124119a8602）;科技部“十二五”国家科技支撑项目（2012BA101804）

摘　　要：目的：编制轻症抑郁障碍的结构式团体认知行为治疗方案,评估其可行性.方法通过文献检索和临床实践编写针对轻症抑郁患者的结构式团体认知行为治疗手册,以患者治疗前后抑郁症状改善情况、出勤率、脱落率、家庭作业依从性、团体中的表现、总体印象、对本方案的接受程度作为可行性分析指标.结果本研究编制的结构式团体认知行为治疗手册,包括认识轻症抑郁、识别认知和情绪的关系、识别核心信念、学习认知重构和改变核心信念的技术、设立合理生活目标、建立支持系统、预防复发和未来管理等.治疗结束后患者抑郁症状明显缓解,总有效率为67．0％（65/97）,脱落率为9．3％（9/97）.患者出勤率、家庭作业依从性、团体中投入程度、治疗接受程度均较高,总体印象较好,高出勤率占72．2％,作业平均完成率为84．8％,95．0％的患者在团体治疗中投入较高,治疗结束时,98．9％的患者对本治疗持接受态度,94．3％的患者总体印象较好.结论本结构式团体认知行为治疗方案可行性较高,可在相关医疗机构进一步推广.Objective To establish and evaluate the structural of Cognitive Behavioral Group Therapy manual in patients with mild depression.Methods The structural Cognitive Behavioral Group Therapy manual for mild depression,dysthymia and minor depression patients was compiled through lit-erature retrieval and preparation of clinical practice.Depressive symptoms before and after treatment, performance of patients in group （attendance rate,dropped-out rate,homework compliance,commit-ment to the group）and subjective evaluation of patients on the treatment were used to evaluate the feasi-bility of the manual.Results The structural of Cognitive Behavioral Group Therapy manual in this study included being acquainted with mild depression,understanding the relationship between cognition and e-motion,identifying the core beliefs,learning cognitive reconstruction and the technology of changing core beliefs,setting up reasonable life goals,establishing a support system,preventing recurrence and future management and so on.Depressive symptoms were significantly relieved after the treatment,the total effective rate was 67.0%,the dropped-out rate was 9.3%.Attendance rate,homework compli-ance,commitment to the group and acceptance degree of the patients were high,and the overall impres-sion of patients toward this treatment was quite good.The high attendance rate was 72.2%,average homework completion rate was 84.8%,95.0% of the patients committed to the group.At the end of treatment,98.9% of the patients accepted this treatment,94.3% of the patients overall impression was good.Conclusions The feasibility of structural Cognitive Behavioral Group Treatment program is high, and can be further promoted in relevant medical institutions.

关 键 词：轻症抑郁 团体认知行为治疗 结构式 手册 可行性 

分 类 号：R749.94[医药卫生—神经病学与精神病学]