认知行为治疗青少年首发抑郁症患者的临床疗效

A study on cognitive behavioral therapy for adolescent patients with first-onset major depressive disorder

目的探讨认知行为治疗对青少年首次发作的抑郁症患者的功能失调性认知和抑郁、焦虑等负性情绪的疗效。方法对16例青少年抑郁症患者进行4周共8次认知行为治疗合并药物治疗,对照组的16例首发的青少年抑郁症患者单用药物治疗4周,用功能失调性态度问卷(DAS)、贝克抑郁自评问卷(BDI)、焦虑自评量表(SAS)对2组的疗效进行评估。结果1.治疗后研究组的DAS总分[(149.25±14.07)分vs(138.38±9.56)分]、因子D5[(19.50±2.34)分vs(15.31±1.96)分]、D7[(19.31±3.48)分vs(15.19±2.34)分]较治疗前显著性降低,而对照组治疗前后的DAS分改变不明显;治疗后研究组的DAS总分、D1、D5、D7等因子分显著性低于对照组(P<0.05)。2.研究组和对照组相比较,BDI和SAS在治疗前后均差异有显著性。结论认知-行为治疗能显著改善青少年抑郁症患者的功能失调性认知,特别是在脆弱性、寻求赞许、自主性态度的改善上,而对于抑郁、焦虑等负性情绪的疗效则需要进一步证实。

Objective To explore the effect on improving the cognitive function and negative emotion such as depression and anxiety of first-onset major depressive disorder（MDD）. Methods cognitive behavioral therapy（CBT） combined anti-depressive drugs were used in treated 16 cases of first-onset adolescent MDD patients in study group for 4 weeks, anti-depressive drugs only were used in treated 16 cases of first-onset adolescent MDD patients in control group for 4 weeks. DAS （Dysfunctional Attitudes Scales）, BDI（ Beck Depression Inventory）, SAS（Self-Rating Anxiety Scale） were used in evaluated the efficacy of two groups. Results The total score, scores of factors D5, D7 of DAS in study group were significantly decreased after treatment, no positive result in DAS was found in control group. The total score, scores of factors D1, D5, D7 of DAS in study group were significantly lower than which in control group after treatment, while no significant results was found in the comparison of the scores in two groups before treatment. No significant results was found in comparison of the scores of BDI and SAS of two groups before and after treatment. Conclusion CBT was useful in improving the cognitive function of adolescent depressive patients, especially in improving the patients＇ vulnerability, praise-seeking,involuntarily attitudes. While the efficacy of CBT on improving negative emotion such as depression and anxiety are remained to be confirmed.