摘要
目的:从国内外脑卒中后抑郁障碍心理治疗发展现状出发,探讨脑卒中后抑郁障碍心理治疗的有效性和意义。资料来源:应用计算机检索Medline1997-01/2004-08的与脑卒中后抑郁及早期康复相关文献,检索词“stroke,rehabilitation,depression”,并限定文献为英文。同时计算机检索万方数据库2002-01/2004-08相关文献,检索词“脑卒中,心理治疗,抑郁”,并限定文献语种为中文。资料选择:就检索到110余篇文献进行筛选,选择以脑卒中抑郁障碍心理治疗为主要内容文献22多篇,排除综述类文献3篇,其中研究内容相似的,以近5年且发表在权威杂志者优先。资料提炼:筛选到17篇相关文献,包括1124例脑卒中后抑郁患者。其中6篇与神经解剖学因素和非神经因素相关,3篇与生化代谢异常因素相关,8篇与脑卒中后抑郁的心理治疗相关。资料综合:脑卒中后抑郁发生除了有其神经解剖学基础外,还与遗传、心理社会因素、药物因素和局部损伤因素相关,其生化基础涉及多个神经递质系统,其中较为肯定的是去甲肾上腺素系统和5-羟色胺系统。一级预防性心理治疗脑卒中后抑郁可有效减少或避免抑郁症的发生。结论:脑卒中后抑郁发生与多种因素相关,脑卒中早期一级预防性心理治疗对脑卒中后抑郁康复有效。
OBJECTIVE：To probe into the effectiveness and significance of psychological treatment for post-stroke depression based on the temporal related studies. DATA SOURCES： A computer-based search of Medline was conducted to collect the English articles related to post-stroke depression and early rehabilitation published between January 1997 and August 2004 by using the terms “stroke, rehabilitation, depression”. Meanwhile, the related literatures in Chinese published between January 2002 and August 2004 were retrieved in search of Wanfang database with the same terms in Chinese. STUDY SELECTION： Among the more than 110 articles, more than 22 articles about psychological treatment for post-stroke depression, and 3 reviews were excluded. Articles with similar content published in the last five years or in authoritative journals were enrolled preferentially. DATA EXTRACTION： Totally 1 124 cases of post-stroke depression were involved in the 17 related articles. Six articles were associated with neuro-anatomic factors and Non-neural factors,3 articles associated with abnormal biochemical metabolism,and 8 articles associated with psychological treatment for post-stroke depression. DATA SYNTHESIS： Despite of neuro-anatomic factors, occurrence of post-stroke depression was associated with genetic factors, psychosecial factors, drug factors and brain injury. Its biochemical basis was involved in several neurotransmitter systems, especially noradrenaline system and 5- serotonin system.Psychological treatment as primary prevention for treatment of post-stroke depression could decrease effectively, and even avoid depression after stroke. CONCLUSION： Occurrence of post-stroke depression is associated with multiple factors, and psychological treatment as primary prevention is greatly effective in the treatment of post-stroke depression at an early stage of stroke.
出处
《中国临床康复》
CSCD
北大核心
2005年第24期120-121,共2页
Chinese Journal of Clinical Rehabilitation
