摘要
目的:探讨抑郁障碍患者巩固和维持期治疗的有效途径。方法:样本来源于2002-08/2003-12在武汉大学人民医院精神卫生中心门诊或住院、经抗抑郁药物治疗8周,且临床疗效总评量表评分≤3或24项汉密顿抑郁量表总分≤15的首发抑郁症患者60例,随机分为药物+认知组(药物联合心理治疗)和药物组(单纯药物治疗),每组30例。药物+认知组继续原来的药物治疗并联合认知心理治疗,每2周访谈1次;药物组仅继续原来的药物治疗,两组均治疗6个月。于入组前与疗程结束时两次进行汉密顿抑郁量表及临床疗效总评量表的评分,根据汉密顿抑郁量表总分及临床疗效总评量表评分比较两组的痊愈率及复发率。本组计量资料采用t检验,计数资料采用χ2检验。结果:6个月末观察结束时,药物+认知组脱落2例,脱落率7%(2/30);药物组脱落4例,脱落率13%(4/30),两组间脱落率无显著性差异(χ2=0.19,P>0.05)。6例脱落者未纳入统计分析,药物+认知组28例、药物组26例纳入结果分析。药物+认知组痊愈率71%(20/28),复发率7%(2/28);药物组痊愈率42%(11/26),复发率31%(8/26)。两组间痊愈率、复发率均有显著性差异(χ2=4.68,5.24;P=0.03,0.02)。结论:常规药物巩固维持治疗和常规药物联合认知巩固维持治疗均能提高抑郁障碍的痊愈率。常规药物联合认知治疗能更大程度提高痊愈率、减少复发风险。
AIM： To investigate the effective pathway of the therapy for patients with depressive disorders at the phases of consolidation and maintenance. METHODS： From August 2002 to December 2003, 60 inpatients and outpatients with first depression, who were treated with antidepressant for 8 weeks, the score of clinical global impression ≤3 points or the total score of 24-item Hamilton depression scale ≤ 15 points, in the Mental Health Center, Renmin Hospital of Wuhan University, randomly divided into drug＋coguition group （drug combined with psychotherapy, n=30） and drug group （drug therapy only, n=30）. All the patients in both group continued the former drug therapy for 6 months, and those in the drug＋coguition group also received cognitive psychotherapy, they were visited once every two weeks. Before entering the groups and after treatment, all the patients were assessed with Hamilton depression scale and clinical global impression respectively, and the healing rate and relapse rate were compared between the two groups according the total score of Hamilton depression scale and the scores of clinical global impression. The data were calculated with the t test and counted with the chi-squaro test. RESULTS： At the end of the 6~ month, 2 and 4 cases in the drug ＋cognition group and drug group lost respectively, the loss rates were not significantly different between the two groups [7% （2/30）, 13% （4/30）, X^2=0.19,P 〉 0.05] respectively. Six lost cases were not involved in the statistical analysis, 28 cases in the drug＋coguition group and 26 cases in the drug group participated in the analysis of resuhs. The were significant differences in the healing rate and relapse rate between the drug＋coguition group [71% （20/28）; 7% （2/28）] and drug group [42% （11/26）; 31% （8/26）] （X^2=-4.68, 5.24;P=0.03, 0.02）. CONCLUSION： Both routine drug therapy and that combined with cognitive therapy can improve the healing rate of depressive disorders, and the latter can improve the healing rate and reduce the risk of relapse more greatly.
出处
《中国临床康复》
CSCD
北大核心
2005年第24期8-9,共2页
Chinese Journal of Clinical Rehabilitation
