全病程管理联合团体认知行为疗法治疗首发抑郁症的效果研究  

The effect of whole course management combined with group cognitive behavioral therapy in the treatment of firstepisode depression

作　　者：麻钰超 于东升[1] 白延欣[1] 马军[1] 宝继英[1] 韩建芳 王雅靖 MA Yuchao;YU Dongsheng;BAI Yanxin(Mental Health Institute of Inner Mongolia Autonomous Region,Hohhot 010010,China)

机构地区：[1]内蒙古自治区精神卫生中心,内蒙古呼和浩特010010

出　　处：《精神医学杂志》2024年第4期387-390,共4页Journal of Psychiatry

摘　　要：目的探讨全病程管理联合团体认知行为疗法对首发抑郁症患者抑郁焦虑情绪及生活质量的影响。方法选取75例首发抑郁症患者,分为研究组(n=40)和对照组(n=35)。对照组仅接受常规药物治疗,观察组在对照组基础上接受全病程管理联合团体认知行为疗法。治疗后第8、16、24周末,采用汉密尔顿抑郁量表(HAMD)评估抑郁情绪,汉密尔顿焦虑量表(HAMA)评估焦虑情绪,简明幸福与生活质量满意度问卷(Q-LES-Q-SF)评估生活质量。采用重复测量方差分析比较两组HAMD、HAMA、Q-LES-Q-SF评分。结果重复测量方差分析结果显示,HAMD、HAMA、Q-LES-Q-SF评分的时间和组别的交互效应均显著(P<0.001)。简单效应分析结果显示,两组治疗后第8、16、24周末HAMD、HAMA评分均较基线时下降(P<0.05);研究组治疗后第8、16、24周末HAMD、HAMA评分均低于对照组(P<0.001)。研究组治疗后第8、16、24周末Q-LES-Q-SF评分均较基线时升高(P<0.05),对照组治疗后第8、24周末Q-LES-Q-SF评分均较基线时升高(P<0.05);研究组治疗后第8、16、24周末Q-LES-Q-SF评分均高于对照组(P<0.001)。结论全病程管理联合团体认知行为疗法可改善抑郁症患者的抑郁焦虑情绪及生活质量,且远期疗效较好。Objective To explore the effects of whole course management combined with group cognitive behavioral therapy on depression,anxiety,and quality of life in patients with first-episode depression.Methods A total of 75 patients with firstepisode depression were selected and divided into study group(n=40)treated with routine medication and whole course management combined with group cognitive behavioral therapy and control group(n=35)treated only with routine medication.At baseline and at the ends of 8,16"and 24th weeks after treatment,they were all assessed with Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)and Quality of Life Enjoyment and Satisfaction Questionnaire Short Form(Q-LES-QSF).The scores of HAMD,HAMA,and Q-LES-Q-SF between two groups were compared using repeated measures analysis of variance.Results Repeated measures analysis of variance showed that there existed significant differences in interaction effects of time and group for scores of HAMD,HAMA,and Q-LES-Q-SF(P<0.001).At the ends of 8,16"h and 24"weeks after treatment,the scores of HAMD and HAMA in both groups decreased significantly compared with those at the baseline(P<0.05),and the scores of HAMD and HAMA in study group were lower than those in control group(P<0.001).In study group,the QLES-Q-SF scores at the 8",16"and 24"weeks after treatment increased compared with that at baseline,and were higher than those in control group(P<0.05).In control group,the Q-LES-Q-SF scores at the 8"and 24"weekends after treatment increased compared with that at baseline(P<0.05).Conclusion Whole course management combined with group cognitive behavioral therapy can improve depression,anxiety,and quality of life in patients with depression,with good long-term efficacy.

关 键 词：全病程管理模式 团体认知行为疗法 抑郁 生活质量 焦虑 

分 类 号：R749.4[医药卫生—神经病学与精神病学]