心理干预辅助药物治疗帕金森病抑郁与认知障碍

Effects of Psychotherapy on Depression and Cognitive Impairment in Patients with Parkinson's Disease

目的:探讨心理干预对帕金森病(PD)抑郁及认知功能障碍的影响。方法:PD患者70例按入院顺序(单双号)分为心理干预组(在常规药物治疗基础上给予心理干预)和常规治疗组(仅给予常规药物治疗),各35例,于入组、治疗1周及2个月时,采用汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)、简易智能精神状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)对各组患者进行评定,评价心理干预的治疗效果。结果:PD患者存在抑郁及认知障碍。治疗1周后,各组量表评分与入组时差异均无统计学意义。治疗2个月后,心理干预组HAMD评分和SDS评分较入组时和治疗1周时降低(P<0.05),MMSE总分、定向力、计算力、语言评分、MoCA总分、空间/执行功能、命名及语言定向力评分较入组时及治疗1周后提高(P<0.05);常规治疗组仅MMSE定向力评分、MoCA空间/执行功能及定向力评分较入组时和治疗1周时降低(P<0.05);心理干预组HAMD、SDS评分低于常规治疗组(P<0.05),MMSE、MoCA总分高于常规治疗组(P<0.05)。结论:心理干预有助于改善PD患者抑郁与认知功能障碍。

Objective： To explore the effects of psychotherapy on depression and cognitive impairment in patients with Parkinson＇s disease（PD）.Methods： Seventy PD patients were randomly divided into psychotherapy group（n=35） and medication group（n=35）.The depressive symptoms and cognitive impairment were assessed at days 0,7 and 60,using the MMSE,MoCA,SDS,and HAMD scales.Results： Depressive symptoms and cognitive impairment were found in patients with PD.No significant difference of scores was observed at day 7 after psychotherapy.At day 60,HAMD and SDS scores were significantly lower than those at days 0 and 7 in psychotherapy group（P0.05）.According to MMSE test,the total score,factor orientation score,calculation,and speech were significantly higher at day 60 than those in psychotherapy group at days 0 and 7（P0.05）.MoCA test also revealed higher total score,factor executive function score,naming and orientation at day 60 than those measured at days 0 and 7 in psychotherapy group（P0.05）.However,in medication group,only factor orientation score in MMSE and factor executive function and orientation score were significantly higher at day 60 than those at days 0 and 7（P0.05）.The psychotherapy group showed significantly decreased HAMD and SDS score as well as enhanced total score of MMSE and MoCA compared with that of medication group（P0.05）.Conclusion： Psychotherapy helps to attenuate depression and cognitive impairment in patients with PD.