CBT对抑郁发作伴失眠患者的干预研究  

The Study on Effect of CBT in Depression Patients with Insomnia

作　　者：王忠[1] 合浩[1] 李晓霞[1] 王永江 邢崴 易志凯 柳贵明[1] WANG Zhong;HE Hao;LI Xiaoxia;WANG Yongjiang;XING Wei;YI Zhikai;LIU Guiming(Yunnan Psychiatric Hospital,Kunming 650225,China)

机构地区：[1]云南省精神病医院,昆明650225

出　　处：《世界睡眠医学杂志》2021年第9期1492-1494,共3页World Journal of Sleep Medicine

摘　　要：目的:研究认知行为疗法(Cognitive Behavioral Therapy,CBT)改善抑郁发作伴失眠患者的疗效。方法:选取2019年2月1日至2020年2月1日间首次发病并入住云南省精神病医院的抑郁发作伴有失眠的患者97例作为研究对象,采用抽签的方法随机分为观察组(n=48)和对照组(n=49)。观察组在常规抗抑郁药物治疗的基础上增加CBT治疗。对照组进行常规抗抑郁药物治疗。观察CBT对抑郁伴失眠患者睡眠质量的影响。结果:2组患者入组时匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)、总体幸福感量表(General Well Being Schedule,GWB)评分比较差异无统计学意义(P>0.05)。治疗第4周和第8周观察组的PSQI、GWB与对照组比较,差异有统计学意义(P<0.05)。治疗第8周观察组汉密顿抑郁量表(Hamilton Depression Scale,HAMD)评分与对照组比较,差异有统计学意义(P<0.05)。结论:针对抑郁发作伴失眠患者进行CBT治疗后,患者能够更好地处理消极观念,建立合理的睡眠预期、缓解睡前焦虑,激活行为,监控自我,进而改善患者睡眠质量,提高其睡眠满意度,减少使用苯二氮艹卓类药物治疗剂量,缩短苯二氮艹卓类药物使用疗程。所以药物联合CBT治疗对改善抑郁发作伴失眠患者的睡眠质量具有肯定的疗效。Objective:To investigate the effect of Cognitive Behavioral Therapy(CBT)on depression patients with insomnia.Methods:From February 1,2019 to February 1,2020,patients with the first depressive episode and insomnia admitted to Yunnan Psychiatric Hospital were randomly divided into treatment group and control group by drawing lots.The control group received conventional antidepressant medication.The treatment group received CBT on the basis.The effect of CBT on sleep quality in patients with depression and insomnia was observed.Results:There was no statistical significance in Pittsburgh Sleep Quality Index(PSQI)and General Well Being Schedule(GWB)scores between 2 groups at the time of enrollment(P>0.05).At the 4th and 8th week of treatment,PSQI and GWB of the treatment group were significantly different from those of the control group(P<0.05).At the 8th week of treatment,Hamilton Depression Scale(HAMD)score in the treatment group was significantly different from that in the control group(P<0.05).Conclusion:Depression patients with insomnia treated with CBT will be better able to deal with negative idea,set up reasonable expectations,relieve anxiety before going to sleep,activate behavior,monitor the self,and improve sleep quality and sleep satisfaction,reduce the use of benzodiazepines.Therefore,medication combined with CBT has a positive effect on improving the sleep quality of patients with depression and insomnia.

关 键 词：认知行为疗法 抑郁发作 失眠 

分 类 号：R395.5[哲学宗教—心理学]