抑郁障碍正念认知治疗中心理弹性的作用  

Effect of resilience in mindfulness-based cognitive therapy in patients with depression

作　　者：武雅学 刘磊[1] 曹学玲 张丽霞[1] 李献云 赵荣荣 李春秋 茹淑静 谭云龙[1] 李艳丽[1] WU Yaxue;LIU Lei;CAO Xueling;ZHANG Lixia;LI Xianyun;ZHAO Rongrong;LI Chunqiu;RU Shujing;TAN Yunlong;LI Yanli(Peking University Huilongguan Clinical Medicine School,Beijing Huilongguan Hospital,Beijing 100096,China)

机构地区：[1]北京大学回龙观临床医学院,北京回龙观医院,北京100096

出　　处：《中国心理卫生杂志》2021年第7期529-534,共6页Chinese Mental Health Journal

基　　金：首都特色临床科学基金项目——正念认知疗法治疗抑郁障碍的疗效量化评估和规范化研究(Z171100001017103);北京市属医院科研培育计划项目——静观认知疗法治疗抑郁障碍的疗效评价及预防复发的随机对照研究(PX2018067)。

摘　　要：目的:评价对药物干预后尚残留症状的抑郁障碍患者开展正念认知治疗(MBCT)的增效作用,并探索心理弹性在MBCT的增效作用中的影响。方法:采用自身前后对照设计,纳入药物治疗半年以上仍存在残留症状的48例抑郁障碍患者,开展为期8周的MBCT治疗,于干预前后进行汉密顿抑郁量表17条目(HAMD-17)、汉密顿焦虑量表(HAMA)、五因素正念量表(FFMQ)、大五人格量表(NEOFFI)、心理弹性量表(CD-RISC)评估。对干预前后评分差值进行回归分析。结果:在4周末和8周末,HAMD-17、HAMA总分均较基线下降(均P<0.01),FFMQ总分较基线升高(均P<0.01);8周末NEOFFI的神经质因子分升高、外向性因子分降低(均P<0.05),CD-RISC评分较基线增升高(均P<0.01)。回归分析显示:FFMQ总分差值与HAMA总分差值(β=-0.23)、CD-RISC的力量性因子分差值均呈线性相关(β=0.18)。结论:MBCT改善了抑郁障碍患者经药物干预后的残留症状,而心理弹性的提升可能是MBCT促进抑郁障碍进一步改善的机制。Objective:To evaluate the synergistic effect of further development of mindfulness based cogni-tive therapy(MBCT)in patients with depression with residual symptoms after drug intervention,and to explore the effect of resilience in the synergistic effect of MBCT.Methods:By using self-comparison method,48 patients with depression who still had residual symptoms after drug treatment for more than half a year were inchuded.By treated with MBCT for 8 weeks,they were assessed with the Hamilton Rating Scale for Depression-17(HAMD-17),Hamil-ton Rating Scale for Anxiety(HAMA),Five Facet Mindfulness Questionnaire(FFMQ),NEO Five-Factor Inventory(NEO-FFI),and Connor-Davidson Resilience Scale(CD-RISC)before and after the intervention,respectively.Furthermore,regression analysis was performed with each subscales change.Results:At the end of the 4th and 8th weekend,the total scores of HAMD-17 and HAMA decreased from baseline(Ps<0.01),and the total FFMQ scores increased from baseline(P<0.01).After the 8-week intervention,NEO-FFI neurotic factor scores in-creased,NEO-FFI extroversion factor scores decreased(Ps<0.05),and CD-RISC scores increase(P<0.01).Re-gression analysis showed that FFMQ total score were associated with HAMA total score difference(β=-0.23)and CD-RISC power factor score difference(β=0.18).Conclusion:It suggests that MBCT could improve the re-sidual symptoms of patients with depression after drug intervention,and the improvement of psychological resilience may be the mechanism of MBCT's synergistic effect on the treatment of depression.

关 键 词：正念认知治疗 抑郁障碍 残留症状 心理弹性 

分 类 号：R749.059[医药卫生—神经病学与精神病学] R749.41[医药卫生—临床医学]