上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2015, Vol. 35 ›› Issue (10): 1485-.doi: 10.3969/j.issn.1674-8115.2015.10.011

• 论著（临床研究） • 上一篇    下一篇

#br# 简化认知行为治疗对广泛性焦虑患者生活质量的影响

张丽，朱智佩，蒋江灵，李伟，李春波   

  1. 上海交通大学 医学院附属精神卫生中心， 上海200030
  • 出版日期:2015-10-20 发布日期:2015-12-22
  • 通讯作者: 李春波, 电子信箱: chunbo_li@163.com
  • 作者简介:张丽（1990—）， 女， 硕士生; 电子信箱: 1178948088@qq.com
  • 基金资助:

    科技部“十二五”国家科技支撑项目（2012BAI01B04）

Effects of simplified cognitive behavior therapy on the quality of life of patients with generalized anxiety disorder

ZHANG Li, ZHU Zhi-pei, JIANG Jiang-ling, LI Wei, LI Chun-bo   

  1. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai200030, China
  • Online:2015-10-20 Published:2015-12-22
  • Supported by:

    National Key Technology Research and Development Program of the Ministry of Science and Technology of China in the “12th Five-year Plan”, 2012BAI01B04

PDF (PC)

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摘要：

目的比较简化认知行为治疗（SCBT）、药物治疗以及联合治疗3种干预方式对广泛性焦虑（GAD）患者生活质量的影响。方法针对符合DSM-5 中GAD标准，目前处于发作期的患者，运用SCBT方法，采用多中心平行对照、盲法评估的方法，分为SCBT组、SCBT＋药物组和药物组。主要结局指标为生命质量评分。结果完成8周干预103例患者，男51例，女52例，平均年龄是（37.8±11.6）岁；3组分别为32、38、33例，3组在年龄、性别和教育程度等方面的差异无统计学意义（P>0.05)。基线时3组间仅在社会功能上差异有统计学意义（F=3.469，P=0.035），SCBT+药物组明显低于其他两组；8周末，协方差分析结果表明，3组仅在躯体疼痛上差异有统计学意义（F=3.644，P=0.030），药物组明显高于其他两组。组内比较结果显示：SCBT组除躯体健康问题导致的角色受限、生命活力维度外，其他6个维度量表评分在治疗前后的差异有统计学意义（P<0.05）；SCBT+药物组在8个维度上治疗前后的差异均有统计学意义（P<0.05）；药物组除躯体功能,其他7个维度量表评分在治疗前后的差异有统计学意义（P<0.05)。3组间HAMA评分差异有统计学意义（P<0.05)；3组HAMD评分差异无统计学意义（P>0.05)。结论单用SCBT、药物治疗及联合治疗3种干预方式均有助于改善GAD患者的生活质量，三者间差异不显著。

关键词: 简化认知行为治疗, 广泛性焦虑, 生活质量, 疗效

Abstract:

ObjectiveTo compare the effects of simplified cognitive behavior therapy (SCBT), drug therapy, and combined therapy on the quality of life of patients with generalized anxiety disorder (GAD).MethodsPatients with onset of GAD who conformed to the standard of DSM-5 were divided into the SCBT group, SCBT+drug group, and drug group. SCBT, multi-center parallel control method, and blind evaluation were adopted. The major outcome index was the score of quality of life.ResultsA total of 103 patients completed 8 weeks of intervention. Among them, 51 patients were male and 52 patients were female with average age of (37.8±11.6) years. The numbers of patients of three groups were 32, 38, and 33. The differences of age, gender, and education level of three groups were not statistically significant（P>0.05). At baseline, only the difference of social function of three groups was statistically significant (F=3.469, P=0.035) and the level of SCBT+drug group was obviously lower than that of other two groups. By the end of the 8 weeks, the covariance analysis showed that only the difference of body pain of three groups was statistically significant (F=3.644, P=0.030) and the level of drug group was obviously higher than that of other two groups. Comparison among groups indicated that except the role limitation and vitality due to the physical health problem, the differences of scores of other 6 dimensions of the SCBT group before and after treatment were statistically significant (P<0.05). The differences of scores of all 8 dimensions of the SCBT+drug group before and after treatment were statistically significant (P<0.05). Except the body function, the differences of scores of other 7 dimensions of the drug group before and after treatment were statistically significant (P<0.05). The differences of HAMA scores of three groups were statistically significant (P<0.05). The differences of HAMD scores of three groups were not statistically significant (P>0.05).ConclusionSCBT, drug therapy, and combined therapy are all helpful for improving the quality of life of GAD patients and the differences of three therapies are no significant.

Key words: simplified cognitive behavior therapy, generalized anxiety disorder, quality of life, curative effect