米氮平联合CCBT治疗轻中度抑郁症的效果及对生活质量的影响  

Effect of mirtazapine combined with computerized cognitive behavioral therapy on mild to moderate depression and its impact on quality of life

作　　者：范燕飞 孙红立[2] 刘美玲 胥爱萍 Fan Yanfei;Sun Hongli;Liu Meiling;Xu Aiping(The First Affiliated Hospital,Anhui Medical University,Hefei 230022,China;Weifang Mental Health Center,Weifang 261061,China)

机构地区：[1]安徽医科大学第一附属医院,安徽合肥230022 [2]潍坊市精神卫生中心,山东潍坊261061

出　　处：《四川精神卫生》2019年第5期413-417,共5页Sichuan Mental Health

基　　金：潍坊市科技发展计划项目(2018YX065)

摘　　要：目的探讨米氮平联合计算机化认知行为治疗(CCBT)对轻中度抑郁症的效果及对患者生活质量的影响,为轻中度抑郁症的心理治疗提供参考。方法选取96例符合《精神障碍诊断与统计手册(第5版)》(DSM-5)诊断标准的轻中度抑郁症患者,采用随机数字表法分为研究组和对照组各48例,对照组给予米氮平,研究组在米氮平治疗基础上联合CCBT,两组均治疗12周。于治疗前及治疗2、4、6、12周后采用汉密尔顿抑郁量表17项版(HAMD-17)评定患者抑郁症状及疗效,治疗前后采用世界卫生组织生存质量评定量表简表(WHOQOL-BREF)评定生活质量,治疗期间采用副反应量表(TESS)评定安全性,治疗12周后采用Morisky治疗依从性问卷(MMAS-8)评定治疗依从性。结果治疗12周末,研究组HAMD-17评分均低于对照组(P均<0.05)。研究组WHOQOL-BREF的生理领域、心理领域、社会关系领域、环境领域、总体健康状况、总体生活质量评分均高于对照组(Р均<0.01)。治疗后研究组治疗依从性高于对照组(P<0.05)。结论米氮平联合CCBT对轻中度抑郁症的效果及对患者生活质量的影响优于单用米氮平治疗。Objective To explore the effect of mirtazapine combined with computerized cognitive behavioral therapy(CCBT)on mild to moderate depression and the quality of life of patients,and to provide references for the psychotherapy of mild to moderate depression.A total of 96 patients with mild to moderate depression who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)were selected and divided into study group and control group by random number table method.The control group was given mirtazapine,and the study group was treated with mirtazapine combined with CCBT for 12 weeks.The Hamilton Depression Scale-17 item(HAMD-17)was used to evaluate depressive symptoms and efficacy before and after 2,4,6 and 12 weeks of treatment.The World Health Organization Quality of Life Scale(WHOQOL-BREF)was used to evaluate quality of life before and after treatment.At the end of the 12th week,the Morisky Medication Adherence Scale-8 item(MMAS-8)was used to evaluate treatment adherence.Treatment Emergent Symptom Scale(TESS)was used in the treatment to evaluate the side effects of the drug.Results At treatment for 12 weeks,the HAMD-17 score of the study group was lower than that of the control group(P<0.05).The scores of WHOQOL-BREF’s physiological,psychological,social relationship and environmental field,overall health status and quality of life in study group were lower than those of the control group(P<0.01).After treatment,the score of MMAS-8 in the study group was higher than that of the control group(P<0.05).There was no significant difference in adverse drug reactions between the two group(P>0.05).Conclusion The effect of mirtazapine combined with CCBT on mild and moderate depression and quality of life is better than that of mirtazapine alone.

关 键 词：抑郁症 计算机化认知行为治疗 生活质量 

分 类 号：R749.4[医药卫生—神经病学与精神病学]