心智化家庭治疗对青少年抑郁障碍患者抑郁症状及非自杀性自伤行为的影响  

Effect of mentalization-based family therapy on depressive symptoms and non-suicidal self-injury behavior in adolescents with major depressive disorder

作　　者：韩利[1] 王娟[1] 张小梅 石艳[1] 唐中玉[1] 梅翠红 Han Li;Wang Juan;Zhang Xiaomei;Shi Yan;Tang Zhongyu;Mei Cuihong(Wuhan Mental Health Center,Wuhan 430000,China;Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]武汉市精神卫生中心,湖北武汉430000 [2]华中科技大学同济医学院附属同济医院,湖北武汉430030

出　　处：《四川精神卫生》2023年第6期491-496,共6页Sichuan Mental Health

基　　金：2022年湖北省自然科学基金项目(项目名称:基于移动医疗的青少年精神障碍患者非自杀性自伤动态管理模式与应用,项目编号:2022CFB483)。

摘　　要：背景青少年抑郁障碍患病率高,且患者多伴有非自杀性自伤(NSSI)行为。改善青少年抑郁障碍患者病情已成为临床关注的重点。目的探讨心智化家庭治疗(MBFT)对青少年抑郁障碍患者抑郁症状及NSSI行为的影响,为促进青少年抑郁障碍患者康复提供参考。方法于2022年1月—12月选取武汉市精神卫生中心收治的符合《国际疾病分类(第10版)》(ICD-10)抑郁障碍诊断标准的90例青少年抑郁障碍患者为研究对象,采用随机数字表法分为研究组(n=44)和对照组(n=46)。两组均接受常规干预,研究组在此基础上接受为期8周、每周1次、每次60 min的MBFT干预。分别于干预前和干预第1、2、4、8周末,对两组患者进行汉密尔顿抑郁量表24项版(HAMD-24)、自我效能感量表(GSES)、匹兹堡睡眠质量指数量表(PSQI)以及渥太华自我伤害调查表(OSI)评定。结果重复测量方差分析结果显示,干预前和干预第1、2、4、8周末,两组HAMD-24评分(F=69.621、15.428、29.623,P均<0.05)、OSI总评分(F=176.642、37.682、21.873,P均<0.05)、GSES评分(F=215.236、57.421、27.857,P均<0.05)和PSQI评分(F=268.541、61.863、33.867,P均<0.05)的时间主效应、组别主效应以及组别与时间的交互效应均有统计学意义。单独效应分析显示,干预第2、4、8周末,研究组和对照组HAMD-24评分(t=5.567、8.645、6.233,P均<0.01)、OSI总评分(t=3.675、11.817、9.632,P均<0.01)、GSES评分(t=23.462、31.709、12.750,P均<0.01)、PSQI评分(t=9.664、22.457、9.333,P均<0.01)差异均有统计学意义。结论MBFT可能有助于改善青少年抑郁障碍患者的抑郁症状、NSSI行为和睡眠质量,提升其自我效能感。Background The major depressive disorder has high prevalence among adolescents,and non-suicidal self-injury(NSSI)behaviors frequently occur among patients,therefore,major depressive disorder in adolescents has become the researching focus.Objective To explore the effect of mentalization-based family therapy(MBFT)on depressive symptoms and NSSI behavior in adolescents with major depressive disorder,and to provide references for the rehabilitation of major depressive disorder in adolescents.Methods A total of 90 adolescent patients with major depression disorder who met the diagnostic criteria of International Classification of Diseases,10th edition(ICD-10)for depressive disorders and attended Wuhan Mental Health Center from January to December 2022 were selected,and were assigned into study group(n=44)and control group(n=46)using random number table method.All participants received routine intervention,based on this,study group added a 60-minute MBFT intervention once a week for 8 weeks.Before the intervention and at the end of 1st,2nd,4th and 8th week,the two groups were assessed using Hamilton Depression Scale-24 item(HAMD-24),General Self-Efficacy Scale(GSES),Pittsburgh Sleep Quality Index(PSQI)and Ottawa Self-injury Inventory(OSI).Results The repeated measures analysis of variance reported a statistical main effect of time,main effect of group,and interaction effect between time and group at the baseline and the end of 1st,2nd,4th and 8th week of treatment in HAMD-24 score(F=69.621,15.428,29.623,P<0.05),OSI score(F=176.642,37.682,21.873,P<0.05),GSES score(F=215.236,57.421,27.857,P<0.05)and PSQI score(F=268.541,61.863,33.867,P<0.05).Individual effect analysis discovered a statistical difference between study group and control group at the end of 2nd,4th and 8th week of treatment in HAMD-24 score(t=5.567,8.645,6.233,P<0.01),OSI score(t=3.675,11.817,9.632,P<0.01),GSES score(t=23.462,31.709,12.750,P<0.01)and PSQI score(t=9.664,22.457,9.333,P<0.01).Conclusion MBFT may improve depressive symptoms,NSSI behavior,sleep

关 键 词：青少年 抑郁障碍 MBFT 自我效能感 非自杀性自伤行为 睡眠质量 

分 类 号：R749.4[医药卫生—神经病学与精神病学]