上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (05): 619-625.doi: 10.3969/j.issn.1674-8115.2020.05.009

• 论著·临床研究 • 上一篇    下一篇

简化认知行为治疗对广泛性焦虑的疗效研究

张 丽1，方 芳1，朱智佩2, 3，申 远4，柳 娜5，李春波3   

  1. 1.上海市虹口区精神卫生中心心理科，上海 200083; 2.上海市普陀区精神卫生中心防治科，上海 200065；3. 上海交通大学医学院附属精神卫生中心，上海市重性精神病重点实验室，上海 200030；4.同济大学附属第十人民医院精神科，上海 200072；5.南京医科大学附属脑科医院医学心理科，南京 210029
  • 出版日期:2020-05-28 发布日期:2020-05-28
  • 通讯作者: 李春波，电子信箱：licb@smhc.org.cn。
  • 作者简介:张 丽（1990—），女，硕士生；电子信箱：18721899506@ 163.com。
  • 基金资助:
    国家重点研发计划（2018YFC2001605）；上海市2015年度“科技创新行动计划”医学和农业领域科技支撑项目（15411950201）；上海市医学重点专科建设计划（ZK2019A06）；上海市卫生和计划生育委员会科研课题青年项目（20154Y0080）；虹口区卫生和计划生育委员会医学科研课题（虹卫1803-08）； 虹口区公共卫生优秀青年人才培养计划(HKGWYQ2018-01）。

Effect of simplified cognitive behavioral therapy on generalized anxiety disorder

ZHANG Li1, FANG Fang1, ZHU Zhi-pei2, 3, SHEN Yuan4, LIU Na5, LI Chun-bo3   

  1. 1. Department of Clinical Psychology, Shanghai Hongkou Mental Health Center, Shanghai 200083, China; 2. Prevention and Treatment Department, Shanghai Putuo Mental Health Center, Shanghai 200065, China; 3. Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 4. Department of Psychiatry, Tenth People’s Hospital of Tongji University, Shanghai 200072, China; 5. Department of Clinical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
  • Online:2020-05-28 Published:2020-05-28
  • Supported by:
    National Key R&D Program of China (2018YFC2001605); Shanghai “Science and Technology Innovation Action Plan” Science and Technology Support Project in Medicine and Agriculture in 2015 (15411950201); Shanghai Construction Plan of Key Medical Specialty (ZK2019A06); Shanghai Health and Family Planning Commission Scientific Research Project for Youth (20154Y0080); Medical Research Program of Hongkou Health and Family Planning Committee (1803-08); Outstanding Young Talents Training Plan of Hongkou District in Public Health (HKGWYQ2018-01).

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摘要： 目的·探索简化认知行为治疗（simplified cognitive behavioral therapy，SCBT）对广泛性焦虑（generalized anxiety disorder，GAD）患者的疗效。方法·招募就诊于上海市虹口区精神卫生中心、上海市普陀区精神卫生中心、同济大学附属第十人民医院、南京医科大学附属脑科医院、上海交通大学医学院附属精神卫生中心的GAD患者，分为SCBT组、SCBT+药物组和药物组。采用广泛性焦虑量表-7（Generalized Anxiety Disorder Scale-7，GAD-7）评估患者的广泛性焦虑症状，汉密尔顿焦虑量表-14（Hamilton Anxiety Scale-14，HAMA-14）评估患者的焦虑程度，汉密尔顿抑郁量表-17（Hamilton Depression Scale-17，HAMD-17）评估患者的抑郁程度。以SCBT法和/或药物治疗，采用单盲法对3组患者进行评估。采用方差分析、χ2检验比较3组的治愈率，以及不同时点焦虑、抑郁的严重程度。结果·纳入统计分析134例，其中SCBT组39例、SCBT+药物组53例、药物组42例。3组间性别、教育程度、婚姻状况比较差异无统计学意义，年龄比较差异有统计学意义（P=0.033）。3组间治愈率比较差异有统计学意义（P=0.005）；SCBT组治愈率高于SCBT+药物组和药物组。3组的焦虑得分、抑郁得分随治疗时间的延长呈下降趋势。结论·SCBT能有效缓解GAD患者的焦虑和抑郁症状，且对GAD患者的预后较好。

关键词: 简化认知行为治疗, 广泛性焦虑, 焦虑, 抑郁, 疗效

Abstract:

Objective · To explore the effect of simplified cognitive behavioral therapy (SCBT) on generalized anxiety disorder (GAD). Methods · GAD patients were recruited from Shanghai Hongkou Mental Health Center, Shanghai Putuo Mental Health Center, Tenth People’s Hospital of Tongji University, The Affiliated Brain Hospital of Nanjing Medical University and Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, who were divided into SCBT group, SCBT+medication group and medication group. The Generalized Anxiety Disorder Scale-7 (GAD-7) was used to assess the patients' generalized anxiety symptoms, Hamilton Anxiety Scale-14 (HAMA-14) to assess the patients' anxiety level, and Hamilton Depression Scale-17 (HAMD-17) to assess the patients' depression level. SCBT and/or medication were used. Three groups of patients were evaluated by single blind method. Variance analysis and χ2 test were used to compare the cure rate and the severity of anxiety and depression at different time points. Results · A total of 134 cases were included in the statistical analysis, 39 cases in SCBT group, 53 cases in SCBT+medication group, and 42 cases in medication group. There was no significant difference in gender, education level and marital status among the three groups, and there was significant difference in age (P=0.033). The cure rate of SCBT group was higher than those of SCBT+medication group and medication group (P=0.005). The scores of anxiety and depression of the three groups decreased with the prolongation of treatment time. Conclusion · SCBT can effectively alleviate the anxiety and depression symptoms of GAD patients, and has a better prognosis for GAD patients.

Key words: simplified cognitive behavioral therapy (SCBT), generalized anxiety disorder (GAD), anxiety, depression, efficacy

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