认知行为疗法联合抗抑郁剂治疗对男性酒依赖患者的疗效分析  

The Effect of Integration of Cognitive Behavioral Therapy and Antidepressant Treatment on Male Alcohol Dependent Patients:An Efficacy Analysis

作　　者：陈志恩 金国林 吴飞燕 岳静 康艳宝 CHEN Zhien;JING Guolin;WU Feiyan;YUE Jing;KANG Yanbao(Department of Psychiatry,The Second People's Hospital of Lishui,Lishui 323000,Zhejiang)

机构地区：[1]丽水市第二人民医院精神医学科,浙江丽水323000

出　　处：《丽水学院学报》2022年第2期74-81,共8页Journal of Lishui University

基　　金：丽水市公益性技术应用研究项目“认知行为疗法联合抗抑郁剂治疗对男性酒依赖患者的远期疗效及戒酒影响”(2017GYX29)。

摘　　要：为探讨认知行为疗法(CBT)对男性酒依赖患者的疗效,顺次收集符合ICD—10和DSM-Ⅳ-TR中有关酒依赖诊断标准的100例男性住院患者,根据治疗方式不同随机分为研究组(CBT+SSRIs)和对照组(SSRIs),各50例,随访观察1年。联合应用自制问卷、强制性饮酒问卷(OCDS)、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、世界卫生组织生存质量测定量表简表(WHOQOL—BREF)进行综合评估分析。(1)OCDS评分:治疗2周后研究组总体减分有统计学意义(F=11.5,P<0.01),而对照组无统计学意义;治疗2周后两组间在各时点减分比较,差异均有统计学意义[t=(6.03、8.21、9.15、7.40),P<0.01]。(2)HAMD评分:两组总体减分均有统计学意义[F=(13.4、10.2),P<0.01];治疗1月后两组间在各时点减分比较,差异均有统计学意义[t=(3.63、2.29、2.54),P<0.05或P<0.01]。HAMA评分:两组总体减分均有统计学意义,但研究组比对照组减分更显著[(F=12.3,P<0.01)VS(F=3.29,P<0.05)];两组间在各时点的减分比较,差异均有统计学意义[t=(5.23、5.43、2.80、2.76),P<0.01]。(3)WHOQOL—BREF评分:治疗12月后在生理、心理、社会三个领域,两组治疗前后增分均有统计学意义[t=(8.40、5.95),P<0.01]、[t=(9.40、7.07),P<0.01]、[t=(6.26、4.94),P<0.01];两组间增分比较,差异有统计学意义[t=(8.94、2.22、3.77),P<0.01或P<0.05]。治疗12月后在环境领域,研究组较对照组增分更显著[(t=2.22,P<0.05)VS(t=1.49,P>0.05)],但两组间增分比较,差异尚不显著。(4)其他指标:治疗12月后两组患者酒依赖复发率有统计学意义[24%(12/50)vs 46%(23/50),P<0.05],而再住院率、无婚率、失业率等两组差异尚无统计学意义。提示研究组对酒依赖的综合疗效更佳,表明CBT对于降低患者心理渴求,改善焦虑、抑郁症状,提高生存质量,降低酒依赖复发率均比单用SSRIs更为有效而持久,以CBT为代表的心理社会干预依然是帮助酒依赖患者保持戒断的基础。To explore the effect of cognitive behavioral therapy(CBT)on male alcohol dependence patients, 100male inpatients who met the diagnostic criteria of alcohol dependence in ICD-10 and DSM-IV-TR were collected.They were randomly divided into a study group(CBT+ SSRIs)and a control group(SSRIs), each with 50 cases based on different treatment methods and were followed up for 1 year. A comprehensive evaluation and analysis was conducted afterwards, using self-made questionnaires, The Obsessive Compulsive Drinking Scale(OCDS),Hamilton Depression Scale(HAMD), Hamilton Anxiety Scale(HAMA), World Health Organization Quality of Life Questionnaire-BREF(WHOQOL—BREF). (1)OCDS score: after 2 weeks of treatment, there is a significant difference in the overall score reduction of the study group(F=11.5, P<0.01), while the control group has no statistical significance. And after 2 weeks of treatment, there were significant differences between the two groups at each time point [t=(6.03, 8.21, 9.15, 7.40), P<0.01]. (2)HAMD score: The overall score reduction in both groups is significant [F=(13.4, 10.2), P<0.01]. The difference between the two groups at each time point after treatment for1 month is statistically significant [t =(3.63, 2.29, 2.54), P<0.05 or P<0.01]. HAMA score: The overall score reduction in both groups was statistically significant, but the study group was more pronounced than the control group [(F=12.3, P<0.01)VS(F=3.29, P<0.05)]. And between the two groups at each time Comparison of points reduction points showed significant differences [t=(5.23, 5.43, 2.80, 2.76), P<0.01]. ⑶WHOQOL-BREF score:after 12 months of treatment, the score increase of the two groups before and after treatment is significant in the three areas of physiology, psychology, and society[t=(8.40, 5.95), P<0.01], [t=(9.40, 7.07), P<0.01], [t=(6.26,4.94), P <0.01]. While the score increase comparison between the two groups, the difference is significant [t=(8.94, 2.22, 3.77), P<0.01 or P< 0.05]. After 12 months of treatment, the study group in

关 键 词：酒依赖 男性 认知行为治疗 抗抑郁剂 病例对照研究 疗效 复发 

分 类 号：R749.62[医药卫生—神经病学与精神病学]