心理干预结合药物治疗对青少年抑郁患者心理防御机制的影响
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摘要
目的:探究心理干预结合药物治疗对青少年抑郁患者心理防御机制的影响。方法:按随机数字表法将172例青少年抑郁患者分为观察组和对照组,每组86例。对照组患者口服抗抑郁药物治疗,观察组在对照组基础上联合心理治疗,采用汉密尔顿抑郁量表(HAMD)、焦虑自评量表(SAS)、90项症状量表(SCL-90)对患者抑郁症状进行评价,采用明尼苏达多项人格测试(MMPI)、防御方式问卷(DSQ)对患者人格及防御机制进行研究。结果:两组患者治疗后HAMD、SAS、SCL-90评分降低,治疗后观察组HAMD、SAS、SCL-90评分显著优于对照组(t=-9.785,-5.460,-9.511;P<0.05);治疗后观察组患者MMPI分中疑病、抑郁、癔症、精神衰弱分值显著低于对照组(t=-8.600,-9.134,-4.530,-7.784;P<0.05);观察组患者治疗后不成熟防御机制评分降低,成熟防御机制评分升高,且观察组患者的不成熟、成熟及中间型防御机制评分均显著优于对照组患者(t=-2.884,2.300,2.488;P <0.05)。结论:心理干预联合药物治疗可有效改善青少年抑郁症患者的不成熟心理防御方式,改变偏激、癔症等不良人格特征,改善抑郁症状,较单一药物治疗效果更好。
Objective:To explore the effect of psychological intervention combined with drug therapy on the psychological defense mechanism of adolescents with depression.Methods:A total of 172 adolescents were divided into the observation group and the control group by the random number table method,86 cases in each group.The control group was treated with oral antidepressant drugs,while on the basis of oral antidepressant drugs,the observation group was given psychological therapy.The depressive symptoms of patients were evaluated with the Hamilton Depression Scale(HAMD),Self-rating Anxiety Scale(SAS)and symptom checklist 90(SCL-90).The personality and defense mechanism of patients were studied by Minnesota Multiphasic Personality Inventory(MMPI)and Defense Style Questionnaire(DSQ).Results:Scores of HAMD,SAS and SCL-90 of the two groups decreased after treatment,and the scores of observation group were significantly better than those of the control group after treatment(t=-9.785,-5.460,-9.511;P<0.05).Scores of hypochondriasis,depression,hysteria and athopia in MMPI of the observation group after treatment were significantly lower than those of the control group(t=-8.600,-9.134,-4.530,-7.784;P<0.05).The immature defense mechanism score of the observation group decreased,while the mature defense mechanism score increased,and scores of immature,mature and intermediate defense mechanism of the observation group were significantly better than those of the control group after treatment(t=-2.884,2.300,2.488,P<0.05).Conclusion:Psychological intervention combined with drug therapy can effectively improve the immature defense style of adolescents with depression,change adverse personality characteristics such as extreme and hysteria,and relieve symptoms of depression.Compared with the single drug therapy,the curative effect is better.
Objective:To explore the effect of psychological intervention combined with drug therapy on the psychological defense mechanism of adolescents with depression.Methods:A total of 172 adolescents were divided into the observation group and the control group by the random number table method,86 cases in each group.The control group was treated with oral antidepressant drugs,while on the basis of oral antidepressant drugs,the observation group was given psychological therapy.The depressive symptoms of patients were evaluated with the Hamilton Depression Scale(HAMD),Self-rating Anxiety Scale(SAS)and symptom checklist 90(SCL-90).The personality and defense mechanism of patients were studied by Minnesota Multiphasic Personality Inventory(MMPI)and Defense Style Questionnaire(DSQ).Results:Scores of HAMD,SAS and SCL-90 of the two groups decreased after treatment,and the scores of observation group were significantly better than those of the control group after treatment(t=-9.785,-5.460,-9.511;P<0.05).Scores of hypochondriasis,depression,hysteria and athopia in MMPI of the observation group after treatment were significantly lower than those of the control group(t=-8.600,-9.134,-4.530,-7.784;P<0.05).The immature defense mechanism score of the observation group decreased,while the mature defense mechanism score increased,and scores of immature,mature and intermediate defense mechanism of the observation group were significantly better than those of the control group after treatment(t=-2.884,2.300,2.488,P<0.05).Conclusion:Psychological intervention combined with drug therapy can effectively improve the immature defense style of adolescents with depression,change adverse personality characteristics such as extreme and hysteria,and relieve symptoms of depression.Compared with the single drug therapy,the curative effect is better.
引文
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[3]古力巴克然木·阿布拉,马瑞,胡曼娜,等.西酞普兰联合心理干预对抑郁症患者症状及认知功能的疗效[J].国际精神病学杂志,2017,5(4):625-627
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[9]邹义壮,冯锋.明尼苏达多项人格问卷第二版(MMPI-2)情况介绍[J].中国心理卫生杂志,1990,11(4):31-32
[10]李宁宁,王旭梅,姜潮,等.防御方式问卷信效度再验证[J].中华行为医学与脑科学杂志,2014,23(1):80-82
[11]李玉霞.青少年抑郁、焦虑情绪与其相关因素[J].中国健康心理学杂志,2013,21(3):415-417
[12]朱晓茜.舍曲林联合认知训练治疗儿童青少年抑郁症的临床观察[J].神经损伤与功能重建,2016,11(3):233-235
[13]卢微,谭扬亚,刘彦茹,等.小组心理护理在青少年抑郁症患者中的临床效果[J].国际精神病学杂志,2016,12(6):1055-1058
[14]付玉喜,毕素芝,韩卫军.健康心理干预疏导治疗抑郁症的临床研究[J].河北医药,2016,38(21):3358-3360
[15]刘星星.心理干预法对抑郁症患者的临床疗效观察[J].安徽医药,2013,18(4):653-655
[16]章虹,汪道鑫.抑郁症患者的生活事件、心理防御机制与其发病相关性研究[J].中国现代医学杂志,2010,20(9):1342-1344
[17]李赓,曹艳玲,李丽梅,等.抑郁症共病焦虑障碍患者病理心理学相关因素分析[J].宁夏医科大学学报,2016,38(12):1420-1423
[18]姜义彬,陈文泽,徐桥.辅助心理干预对抑郁症患者心理防御方式影响的研究[J].中国康复,2013,28(6):451-453
[2]张红英,王军,李新影,等.父母受教育程度在积极心理品质对青少年抑郁症状影响中的调节作用[J].中国全科医学,2016,19(24):2975-2981
[3]古力巴克然木·阿布拉,马瑞,胡曼娜,等.西酞普兰联合心理干预对抑郁症患者症状及认知功能的疗效[J].国际精神病学杂志,2017,5(4):625-627
[4]徐丽红,戴涛.认知行为团体心理治疗对抑郁症患者抑郁症状以及应对方式社会支持影响的干预研究[J].中国药物与临床,2016,16(9):1347-1349
[5]中华医学会精神病学分会.中国精神障碍分类与诊断标准第三版(精神障碍分类)[J].中华精神科杂志,2001,34(3):184-188
[6]胡旭强,钱敏才,林敏,等.斯奈思-汉密尔顿快感量表中文版测评抑郁症患者的效度和信度[J].中国心理卫生杂志,2017,31(8):625-629
[7]陶明,高静芳.修订焦虑自评量表的信度及效度[J].中国神经精神疾病杂志,1994,5(5):301-303
[8]王姿欢,俞文兰,沈壮,等.症状自评量表(SCL-90)应用于中国职业女性心理测评的信效度评价[J].中国工业医学杂志,2017,5(4):247-250
[9]邹义壮,冯锋.明尼苏达多项人格问卷第二版(MMPI-2)情况介绍[J].中国心理卫生杂志,1990,11(4):31-32
[10]李宁宁,王旭梅,姜潮,等.防御方式问卷信效度再验证[J].中华行为医学与脑科学杂志,2014,23(1):80-82
[11]李玉霞.青少年抑郁、焦虑情绪与其相关因素[J].中国健康心理学杂志,2013,21(3):415-417
[12]朱晓茜.舍曲林联合认知训练治疗儿童青少年抑郁症的临床观察[J].神经损伤与功能重建,2016,11(3):233-235
[13]卢微,谭扬亚,刘彦茹,等.小组心理护理在青少年抑郁症患者中的临床效果[J].国际精神病学杂志,2016,12(6):1055-1058
[14]付玉喜,毕素芝,韩卫军.健康心理干预疏导治疗抑郁症的临床研究[J].河北医药,2016,38(21):3358-3360
[15]刘星星.心理干预法对抑郁症患者的临床疗效观察[J].安徽医药,2013,18(4):653-655
[16]章虹,汪道鑫.抑郁症患者的生活事件、心理防御机制与其发病相关性研究[J].中国现代医学杂志,2010,20(9):1342-1344
[17]李赓,曹艳玲,李丽梅,等.抑郁症共病焦虑障碍患者病理心理学相关因素分析[J].宁夏医科大学学报,2016,38(12):1420-1423
[18]姜义彬,陈文泽,徐桥.辅助心理干预对抑郁症患者心理防御方式影响的研究[J].中国康复,2013,28(6):451-453