药物治疗联合团体心理治疗对急性期伴焦虑抑郁的住院精神分裂症患者焦虑抑郁的疗效
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摘要
目的探讨药物治疗联合团体心理治疗对急性期住院精神分裂症患者焦虑抑郁的疗效,为在急性期住院精神分裂症患者中开展团体心理治疗提供参考。方法选取在2015年3月～2016年5月在中山市第三人民医院住院的精神分裂症患者,均符合《国际疾病分类(第10版)》(ICD-10)诊断标准,且初次焦虑自评量表评分> 50分或抑郁自评量表评分> 53分,共136例,按照随机数字表法分为研究组和对照组各68例,两组均接受非典型抗精神病药物治疗,研究组在此基础上接受每周2次的团体心理治疗。于入组时、治疗第2周和第3周采用焦虑自评量表(SAS)、抑郁自评量表(SDS)进行评定。结果 (1)在入组时用SAS和SDS总共评估228例急性期住院患者,符合入组标准的有136例患者,其中共病抑郁障碍136例(59.6%),共病焦虑障碍的有91例(39.9%);(2)经重复测量方差分析,SAS及SDS存在组间主效应(F=44.25,P<0.01;F=19.96,P <0.01),时间主效应(F=353.39,P <0.01;F=193.40,P <0.01)以及两者交互效应(F=6.03,P <0.01;F=3.26,P <0.01)。两组SAS及SDS评分在入组时差异无统计学意义(t=0.83,P>0.05;t=1.31,P> 0.05),在第2周及第3周研究组SAS及SDS评分低于对照组(t SAS=6.56,P <0.01,t SDS=4.49,P <0.01;t SAS=2.15,P <0.05,t SDS=3.58,P <0.05)。结论与药物治疗相比,药物治疗联合团体心理治疗可以更快、更有效地减轻住院精神分裂症患者急性期的焦虑、抑郁症状。
Objective To explore the effect of drug therapy combined with psychotherapy on anxiety and depression in patients with acute schizophrenia and provide reference for psychotherapy in patients with acute schizophrenia. Methods Schizophrenia patients who were admitted to the Third People's Hospital of Zhongshan from March 2015 to May 2016 and were eligible(ICD-10)diagnostic criteria from the International Classification of Diseases(10th Edition).The scores of the scales were greater than 50 points or the scores of the self-rating scale of depression were greater than 53 points,and 136 cases were divided 68 cases each into the study group and the control group according to the random number method.The two groups were treated with atypical antipsychotic drugs and the study group received psychotherapy twice a week.In entering this study,the self-rating anxiety scale(SAS)and the self-rating depression scale(SDS)were used for the second week and the third week of treatment. Results A total of 228 acute hospitalized patients were assessed with SAS and SDS.There were 136 patients who conform to the inclusion criteria,including 136(59.6 percent)of comorbid depression and 91(39.9 percent)of comorbid anxiety disorders.After repeated measures analysis of variance,SAS and SDS had the main effects between groups(F=44.25,P < 0.01;F=19.96,P < 0.01),time main effects(F=353.39,P < 0.01;F=193.40,P < 0.01)and the interaction effects(F=6.03,P < 0.01;F=3.26, P< 0.01).There were no significant differences in SAS and SDS scores between the two groups(t=0.83,P > 0.05;t=1.31,P > 0.05).At the second and third week, the SAS and SDS scores of the study group were lower than the controls(tSAS=6.56,P < 0.01;tSDS=4.49,P < 0.01;tSAS=2.15,P < 0.05;tSDS=3.58,P < 0.05). Conclusion Compared with drug therapy,drug therapy combined with group psychotherapy can alleviate the anxiety and depressive symptoms of patients with schizophrenia in the acute phase more quickly and effectively.
Objective To explore the effect of drug therapy combined with psychotherapy on anxiety and depression in patients with acute schizophrenia and provide reference for psychotherapy in patients with acute schizophrenia. Methods Schizophrenia patients who were admitted to the Third People's Hospital of Zhongshan from March 2015 to May 2016 and were eligible(ICD-10)diagnostic criteria from the International Classification of Diseases(10th Edition).The scores of the scales were greater than 50 points or the scores of the self-rating scale of depression were greater than 53 points,and 136 cases were divided 68 cases each into the study group and the control group according to the random number method.The two groups were treated with atypical antipsychotic drugs and the study group received psychotherapy twice a week.In entering this study,the self-rating anxiety scale(SAS)and the self-rating depression scale(SDS)were used for the second week and the third week of treatment. Results A total of 228 acute hospitalized patients were assessed with SAS and SDS.There were 136 patients who conform to the inclusion criteria,including 136(59.6 percent)of comorbid depression and 91(39.9 percent)of comorbid anxiety disorders.After repeated measures analysis of variance,SAS and SDS had the main effects between groups(F=44.25,P < 0.01;F=19.96,P < 0.01),time main effects(F=353.39,P < 0.01;F=193.40,P < 0.01)and the interaction effects(F=6.03,P < 0.01;F=3.26, P< 0.01).There were no significant differences in SAS and SDS scores between the two groups(t=0.83,P > 0.05;t=1.31,P > 0.05).At the second and third week, the SAS and SDS scores of the study group were lower than the controls(tSAS=6.56,P < 0.01;tSDS=4.49,P < 0.01;tSAS=2.15,P < 0.05;tSDS=3.58,P < 0.05). Conclusion Compared with drug therapy,drug therapy combined with group psychotherapy can alleviate the anxiety and depressive symptoms of patients with schizophrenia in the acute phase more quickly and effectively.
引文
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[11]汪向东,王希林,马弘.心理卫生评定量表手册[M].增订版.北京:中国心理卫生杂志社,1999:127-131.
[12]崔宇.精神分裂症患者与焦虑障碍共病发病率调查:194例特征[J].中国临床康复,2005,9(40):42-44.
[13]范继美,田素英.住院精神病病人心理需要情况的调查分析[J].全科护理,2009,11(7):78-79.
[14]汪作为,方贻儒,张少平.精神分裂症抑郁研究进展[J].中国行为医学科学,2007,16(1):88-89.
[15]谌霞灿.精神分裂症伴抑郁症状的研究[J].临床和实验医学杂志,2008,7(9):157-158.
[16]韦少俊,黄信荣.精神分裂症伴发抑郁的研究[J].柳州医学,2010,23(3):92-94.
[17]张杏莲,许建雄,谢建文,等.集体心理治疗对住院精神分裂症患者的作用[J].临床精神医学杂志,2011,21(1):30-32.
[18]粱燕红,卢月芝,植秋禅,等.恢复期精神分裂症患者团体心理治疗对服药依从性的影响[J].中国医药科学,2018,8(2);132-134.
[19]王春,熊卫.重性精神障碍住院患者团体治疗的定性研究[J].中国心理卫生杂志,2013,23(7):508-512.
[20]赵富帅,赵丽丽,张延赤,等.首发精神分裂症患者团体心理治疗的定性研究[J].内蒙古医学杂志,2015,47(10):1200-1202.
[2]李献云,费立鹏,张培琐,等.首发精神分裂症病人的抑郁症状[J].中国神经精神疾病杂志,2001,27(2):95-98.
[3]Na JI,Suh DH.Red light phototherapy alone is effective for acne vulgaris:randomized,single-blinded clinical trial[J].Dermatol Surg,2007,33(10):1228-1233.
[4]季建林,徐美勤.抑郁症和精神分裂症共患焦虑障碍的研究[J].临床精神医学杂志,2004,14(1):9-11.
[5]Zajecka JM,Ross JS.Management of comorbid anxiety and depression[J].J Clin Psychiatry,1995,56(Suppl 2):10-13.
[6]Fawcett J.The detection and consequences of anxiety in clinical depression[J].J Clin Psychiatry,1997,58(Suppl8):35-40.
[7]鲁陆,马玉娟,方耀平.团体心理治疗对康复期精神分裂症患者疗效的影响[J].现代医药卫生,2017,33(11):1680-1682.
[8]徐文耀,梁敏,张春锋.团体心理治疗对精神分裂症患者康复的研究[J].齐齐哈尔医学院学报,2015,36(30):4601-4602.
[9]陈立勇,刘秀丽,张颖.结构式团体心理治疗在精神分裂症康复期的应用研究[J].中国实用神经疾病杂志,2015,18(13):97-98.
[10]欧文,亚龙.觉醒与超越[M].北京:人民邮电出版社,2015:62-65.
[11]汪向东,王希林,马弘.心理卫生评定量表手册[M].增订版.北京:中国心理卫生杂志社,1999:127-131.
[12]崔宇.精神分裂症患者与焦虑障碍共病发病率调查:194例特征[J].中国临床康复,2005,9(40):42-44.
[13]范继美,田素英.住院精神病病人心理需要情况的调查分析[J].全科护理,2009,11(7):78-79.
[14]汪作为,方贻儒,张少平.精神分裂症抑郁研究进展[J].中国行为医学科学,2007,16(1):88-89.
[15]谌霞灿.精神分裂症伴抑郁症状的研究[J].临床和实验医学杂志,2008,7(9):157-158.
[16]韦少俊,黄信荣.精神分裂症伴发抑郁的研究[J].柳州医学,2010,23(3):92-94.
[17]张杏莲,许建雄,谢建文,等.集体心理治疗对住院精神分裂症患者的作用[J].临床精神医学杂志,2011,21(1):30-32.
[18]粱燕红,卢月芝,植秋禅,等.恢复期精神分裂症患者团体心理治疗对服药依从性的影响[J].中国医药科学,2018,8(2);132-134.
[19]王春,熊卫.重性精神障碍住院患者团体治疗的定性研究[J].中国心理卫生杂志,2013,23(7):508-512.
[20]赵富帅,赵丽丽,张延赤,等.首发精神分裂症患者团体心理治疗的定性研究[J].内蒙古医学杂志,2015,47(10):1200-1202.