认知行为干预对抑郁症患者负性情绪和服药依从性的影响(1)
【摘要】 目的：探讨认知行为干预对抑郁症患者负性情绪和服药依从性的影响。方法：86例抑郁症患者按随机数字表法分为对照组和干预组，每组43例。对照组患者接受常规抗抑郁药物治疗及专科护理，干预组在此基础上联合应用认知行为干预。采用24项版汉密尔顿抑郁量表(HAMD-24)、汉密尔顿焦虑量表(HAMA)和Morisky服药依从性量表分别在入组时、治疗6周后对患者进行测评。结果：两组患者入组时HAMD-24、HAMA评分和服药依从性比较差异无统计学意义(P>0.05)；治疗6周后干预组HAMD-24、HAMA评分明显低于对照组，服药依从性明显高于对照组，比较差异均有统计学意义(P<0.05)。结论：认知行为干预能够改善抑郁症患者的抑郁、焦虑情绪，提高服药依从性。
【关键词】 认知行为干预； 抑郁症； 负性情绪； 服药依从性
【Abstract】 Objective：To explore the effects of cognitive behavior intervention on negative emotion and medication adherence in patients with depression.Method：86 patients with depression were divided into control group and intervention group according to the random number table method，43 cases in each group.The control group received conventional antidepressant and nursing.Patients in intervention group were given cognitive behavior intervention additionally.Before and after 6 weeks treatment，negative emotion and medication adherence were evaluated by Hamilton Depression Scale (HAMD-24)，Hamilton Anxiety Scale (HAMA) and Morisky Adherence Scale.Result：Compared with control group，there were no significant differences in scores of HAMD-24，HAMA and percentage of medication adherence in intervention group when entered group (P>0.05).But after 6 weeks treatment，the scores of HAMD-24 and HAMA were significantly lower and the percentage of medication adherence were significantly higher than that of control group，the differences were statistically significant(P<0.05).Conclusion：The cognitive behavior intervention could relieve the depressive and anxious emotion，improve the medication adherence of the patients with depression.
【Key words】 Cognitive behavior intervention； Depression； Negative emotion； Medication adherence
First-author’s address：Shenzhen Kangning Hospital，Shenzhen 518020，China
doi：10.3969/j.issn.1674-4985.2017.07.040
抑郁症是以情绪持续低落和认知功能障碍为主要临床表现、具有反复发作特點的一种慢性精神疾病。抗抑郁药物治疗已被证实是抑郁症的有效治疗手段，而服药不依从行为已成为抑郁症治疗中持续存在的、具有挑战性的一个问题[1-2]。认知行为疗法作为一种通过改变不良认知从而达到消除不良情绪和行为的心理治疗方法，已广泛应用于神经性、躯体性疾病的治疗中[3-6]。本研究在常规抗抑郁药物治疗基础上联合应用认知行为干预，取得较好临床效果，报道如下。
1 资料与方法
1.1 一般资料 以2015年1月-2016年6月本院临床心理科抑郁症住院患者为研究对象，入组标准：(1)符合《中国精神障碍分类与诊断标准》第3版(CCMD-3)诊断标准，经本科主治及以上级别医师诊断为抑郁发作的患者；(2)男女不限，年龄18～65岁；(3)初中以上文化程度；(4)经抗抑郁药物治疗2周以上；(5)24项版汉密尔顿抑郁量表(HAMD-24)总评分≥20分；(6)入组前了解本研究的目的、内容并签署知情同意书。排除标准：(1)合并精神活性物质滥用者；(2)伴有严重躯体疾病者；(3)伴有精神发育迟滞、老年痴呆或人格障碍者；(4)不愿配合本研究者。共86例患者纳入研究，采用随机数字表法随机分为对照组和干预组，每组各43例，其中对照组男18例，女25例；年龄18～57岁，平均(31.3±12.1)岁；病程3～79个月，平均(34.9±21.8)个月。干预组男19例，女24例；年龄18～64岁，平均(34.4±14.2)岁；病程6～88个月，平均(35.9±22.2)个月。两组患者的性别、年龄及病程比较差异均无统计学意义(P>0.05)，具有可比性。, 百拇医药(禹婷婷 徐丹 朱咏娜)
【关键词】 认知行为干预； 抑郁症； 负性情绪； 服药依从性
【Abstract】 Objective：To explore the effects of cognitive behavior intervention on negative emotion and medication adherence in patients with depression.Method：86 patients with depression were divided into control group and intervention group according to the random number table method，43 cases in each group.The control group received conventional antidepressant and nursing.Patients in intervention group were given cognitive behavior intervention additionally.Before and after 6 weeks treatment，negative emotion and medication adherence were evaluated by Hamilton Depression Scale (HAMD-24)，Hamilton Anxiety Scale (HAMA) and Morisky Adherence Scale.Result：Compared with control group，there were no significant differences in scores of HAMD-24，HAMA and percentage of medication adherence in intervention group when entered group (P>0.05).But after 6 weeks treatment，the scores of HAMD-24 and HAMA were significantly lower and the percentage of medication adherence were significantly higher than that of control group，the differences were statistically significant(P<0.05).Conclusion：The cognitive behavior intervention could relieve the depressive and anxious emotion，improve the medication adherence of the patients with depression.
【Key words】 Cognitive behavior intervention； Depression； Negative emotion； Medication adherence
First-author’s address：Shenzhen Kangning Hospital，Shenzhen 518020，China
doi：10.3969/j.issn.1674-4985.2017.07.040
抑郁症是以情绪持续低落和认知功能障碍为主要临床表现、具有反复发作特點的一种慢性精神疾病。抗抑郁药物治疗已被证实是抑郁症的有效治疗手段，而服药不依从行为已成为抑郁症治疗中持续存在的、具有挑战性的一个问题[1-2]。认知行为疗法作为一种通过改变不良认知从而达到消除不良情绪和行为的心理治疗方法，已广泛应用于神经性、躯体性疾病的治疗中[3-6]。本研究在常规抗抑郁药物治疗基础上联合应用认知行为干预，取得较好临床效果，报道如下。
1 资料与方法
1.1 一般资料 以2015年1月-2016年6月本院临床心理科抑郁症住院患者为研究对象，入组标准：(1)符合《中国精神障碍分类与诊断标准》第3版(CCMD-3)诊断标准，经本科主治及以上级别医师诊断为抑郁发作的患者；(2)男女不限，年龄18～65岁；(3)初中以上文化程度；(4)经抗抑郁药物治疗2周以上；(5)24项版汉密尔顿抑郁量表(HAMD-24)总评分≥20分；(6)入组前了解本研究的目的、内容并签署知情同意书。排除标准：(1)合并精神活性物质滥用者；(2)伴有严重躯体疾病者；(3)伴有精神发育迟滞、老年痴呆或人格障碍者；(4)不愿配合本研究者。共86例患者纳入研究，采用随机数字表法随机分为对照组和干预组，每组各43例，其中对照组男18例，女25例；年龄18～57岁，平均(31.3±12.1)岁；病程3～79个月，平均(34.9±21.8)个月。干预组男19例，女24例；年龄18～64岁，平均(34.4±14.2)岁；病程6～88个月，平均(35.9±22.2)个月。两组患者的性别、年龄及病程比较差异均无统计学意义(P>0.05)，具有可比性。, 百拇医药(禹婷婷 徐丹 朱咏娜)