冠心病患者的心理评估及心理干预

A study on psychological assessment and intervention for patients with coronary heart disease

目的探讨因胸痛入院的冠心病患者的心理障碍及针对抑郁情绪进行心理/药物干预治疗的临床效果。方法采用抑郁状态问卷()、症状自评量表(DSISCL蛳90)对114例冠心病患者进行问卷调查,并对其中伴有抑郁情绪者随机分为干预组及对照组,干预组在进行常规治疗的同时给予心理药物干预,比较两组疗效。结果/144例冠心病患者中伴有抑郁情绪者68例,占47.2%。在SCL蛳90调查中显示躯体化、抑郁、焦虑、总分、阳性均分(高于常模)、恐怖、偏执(低于常模)等项因子与常模相比有显著性差异。针对抑郁情绪的心理/物干预能显著降低抑郁评药分(P<0.01),明显改善患者症状,缩短住院时间并减少出院后因症状复发再次就诊次数(P<0.05)。结论冠心病患者可伴有多种心理障碍,有效的心理/药物抗抑郁治疗能促进患者的康复。

Objective To study the psychologic obstacle in inpatients with coronary heart disease(CHD) and the effect of psychological/drug intervention on the patients with depression. Methods Inpatients with CHD were inventoried by DSI and SCL-90. According to the DSI score, depression patients were randomly divided into intervention group and control group, then psychological/drug intervention and relaxation training were performed on the intervention group while routine therapy were performed and to compare the affects between the two groups. Results In 144 CHD patients, the incidence of depression was 47.2%. In the inventory by SCL-90, CHD patients were significantly different for factors somatizations, depression, anxiety, photic anxiety, paranoid ideation, total score and positive average score form internal norm. Performing psychological/drug intervention to relive depression can significantly reduce the DSI score (P < 0.01) improve clinic symptom, reduce stay in hospital and the number of times of returning visit to out-patient clinic for chest pain repeatedly(P < 0.05); Conclusions A series of psychologic obstacle (especially depression) can be expressed on patients of CHD;anti-depress therapy by psychological/drug intervention is helpful to promote recovery of patients.