用认知行为疗法治疗精神分裂症的继发抑郁

Cognitive Behavioral Therapy in Treating Secondary Depression of Schizophrenia

目的：探讨认知行为疗法治疗精神分裂症的继发抑郁的疗效。方法：使用“旧金山预防抑郁研究”教材录制的录像带，对２３例伴有抑郁症状，且符合ＤＳＭ－Ⅳ有关精神分裂症和分裂样精神障碍诊断标准患者，通过看录像进行认知行为疗法，每周一次，８周为一疗程。治疗前后用ＨＡＭＤ、ＣＥＳ－Ｄ、ＨＡＭＡ、ＢＰＲＳ、ＧＡＳ量表评定。结果：认知行为治疗后ＨＡＭＤ、ＣＥＳ－Ｄ、ＨＡＭＡ评分均有逐渐下降趋势、ＧＡＳ评分有逐渐上升趋势（Ｐ＜０．０５），而ＢＰＲＳ评分无显著差异（Ｐ＞０．０５）；治疗６周及８周ＨＡＭＤ减分率与ＢＰＲＳ减分率、ＧＡＳ变化值之间均呈密切相关（Ｐ＜０．０１）。结论：认知行为疗法能改善精神分裂症的抑郁和焦虑症状。

Objective:To study the therapeutic effect of cognitive behavioral therapy on secondarydepression of schizophrenia. Methods:By adapting the videotape from the San Francisco depression prevention study,cognitive behavioral therapy was conducted to 23 schizophrenic patients once a week, who were accompanied with depression and met DSM-Ⅳcriteria for schizophrenia and schizoid psychosis, the duration was eight weeks. Patients were rated with HAMD、CES-D、HAMA 、BPRS and GAS before and after treatment. Results: After treatment, HAMD、CES-D、HAMA scores tended to decrease, while GAS scores increased (P<0.05) and BPRS scores showing no changes(P>0.05). Decreased rate of HAMD scores of six and eight weeks after treatment was closely related to that of BPRS scores and GAS changes (P<0.001).Conclusion:With cognitive behavioral therapy, secondary depression and anxiety of schizophrenia can be ameliorated and overall clinical condition and function level can be improved.