人际心理治疗联合5-羟色胺再摄取抑制剂治疗抑郁症对照研究

A control study of interpersonal psychotherapy combined with SSRI in depression

目的探讨人际心理治疗联合5-羟色胺再摄取抑制剂治疗抑郁症的临床疗效。方法将82例抑郁症患者随机分为研究组与对照组，每组42例，两组均口服5-羟色胺再摄取抑制剂治疗，研究组联合人际心理治疗，观察12w，随访6mo。于治疗前和治疗2w、4w、8w、12w末及随访6mo未采用汉密顿抑郁量表评定临床疗效，随访6mo末依据临床疗效总评量表评定复发率。结果治疗2w末起，两组汉密顿抑郁量表总分均较治疗前有显著性下降（P〈0．01），研究组治疗8w、12w末及随访6mo末均较对照组下降显著（P〈0．05或0．01）。治疗12w末，研究组显效率为83．3％，对照组为60．0％，研究组显著高于对照组（P〈0．05）。随访6mo末，研究组汉密顿抑郁量表总分仍保持较低水平，复发率为7．1％，对照组汉密顿抑郁量表总分较治疗结束时有所上升，复发率为22．5％，研究组复发率显著低于对照组（P〈0．05）。结论人际心理治疗联合5-羟色胺再摄取抑制剂治疗抑郁症较单用5-羟色胺再摄取抑制剂治疗效果更显著，复发率明显下降。

Objective To explore the clinical efficacy of interpersonal psychotherapy （IPT） combined with selective serotonin reuptake inhibitors（SSRIs） in depression. Methods 82 depression patients were randomly assigned to two groups of 42 ones each, both groups received antidepressants, research group was plus IPT for 12 weeks, and followed up for 6 months. The clinical efficacies were assessed with Hamilton Depression Scale（HAMD） before treatment, at the end of the 2^nd ,4^th ,8^th and 12th week and of 6 month follow-up, and the recurernce rates with the Clinical Grobal Impressions Seale（CGI） at the end of 6 month follow-up. Results Since the end of the 2nd week, total scores of the HAMD of both groups lowered more significantly compared with pretreatment（P〈0.01） ; total scores of the HAMD lowered more significantly in the research than in the control group at the ends of the 8^th and 12^th week and the end of 6 month followup（P〈0.05 or 0.01）. At the end of the 12^th week, obvious effective rates were respectively 83.3% in the research and 60.0% in the control group, the former was significantly higher than the latter（P〈0.05）. At the end of 6 month follow up, the total scores of the HAMD still remained low level and recurernce rate was 7.1% in the research, those increased somewhat compared with those at the end of treatment and that was 22.5% in the control group; the recurernce rate was significantly lower in the research than in the control group（P〈0.05）. Conclusion IPT plus SSRIs has a better efficacy than single use of SSRI and the recurernce rate obviously descends.