抗抑郁剂联合认知疗法治疗抑郁症对照研究

A control study of antidepressants plus cognitive therapy in the treatment of depression

目的探讨抗抑郁剂联合认知疗法治疗抑郁症的临床疗效。方法将84例抑郁症患者随机分为研究组与对照组各42例，两组均应用舍曲林联合支持性心理治疗、音乐治疗、运动疗法等一般性心理治疗，研究组在此基础上联合认知心理治疗。观察6w。于治疗前及治疗1w、2w、4w、6w末采用汉密顿焦虑量表、汉密顿抑郁量表评定临床疗效。结果治疗8w末，研究组总有效率为90．48％，对照组为73．81％，两组差异有显著性（χ^2=3．977，P〈0．05）。汉密顿焦虑量表、汉密顿抑郁量表评分，两组治疗1w末起均较治疗前有显著下降（P〈0．01），并随治疗时间的延续均呈持续性下降；同期两组间比较，研究组汉密顿焦虑量表总分治疗2w末起，汉密顿抑郁量表总分治疗4w末起均较对照组下降显著（P〈0．05）。结论抗抑郁剂联合认知心理治疗能显著提高治疗抑郁症的临床疗效。

Objective To explore the curative effect of antidepressants plus cognitive therapy in the treatment of depression. Methods 84 depression patients were randomly divided into study and control group （each n=42）, both groups received sertraline plus psychotherapy, musical therapy and kinetotherapy, study group was plus cognitive therapy in addition,for 6 weeks. The curative effects were evaluated with the Hanmilton Depression Scale（HAMD） and the Hanmilton Anxiety Scale（HAMA） before treatment and at the ends of the 1^st,2^nd,4^th and 6^th week. Results At the end of the 6th week, total effective rates were respectively 90.48% in the study and 73.81% in the control group, the former was significantly higher than the latter（P〈0.05）. Scores of the HAMDand the HAMAof both groups reduced more significantly since the end of the 1^st week compared with pretreatment（P〈0.01） and contiously did along with therapy lasting. According to synchronization inter-group comparisons, the HAMA score since the end of the 2nd week and the HAMD since the end of the 4th week lowered more significantly in the study than in the control group（P〈0.05）. Conclusion Antidepressants plus cognitive therapy can improve the curative effect in the treatment of depression.