老年抑郁症患者的非理性信念和应对方式

Irrational beliefs and coping styles in elderly patients with depression

目的:探讨老年抑郁症患者非理性信念和应对方式的特点。方法:选取63名符合国际疾病和相关健康问题统计分类第十版(ICD-10)诊断标准的老年抑郁症门诊及住院患者,选取30名年龄、性别匹配的正常老年人作为对照。采用老年抑郁量表(GDS)、非理性信念量表(IBS)、简易应对方式问卷(SCSQ)对病例组和对照组在治疗前进行评定,病例组治疗6周后复评一次。结果:病例组治疗前IBS各分量表得分和SCSQ消极应对方式得分均高于对照组,治疗后得分降低(均P<0.001),但仍高于对照组(均P<0.001);病例组治疗前SCSQ积极应对方式得分低于对照组,治疗后得分增加(P<0.001),但仍低于对照组(P<0.001)。治疗后GDS<10的患者非理性信念水平高于对照组(P<0.05),积极应对方式低于对照组(P<0.001),消极应对方式上差异无统计学意义(P>0.05)。病例组治疗前GDS得分与IBS中低挫折耐受、概括化评论得分呈正相关(P<0.001),与SCSQ积极应对得分呈负相关(P<0.05)。结论:老年抑郁症患者存在非理性信念及不良应对方式,临床工作中应给予必要的心理干预,有助于促进康复,减少抑郁复发。

Objective： To investigate the characteristics of irrational beliefs and coping styles in elderly patients with depression. Methods： Totally 63 elderly patients meeting the International Classification of Diseases, Tenth Revision （ICD-10） diagnostic criteria for depression were included as the case group, and 30 age-and gender- matched normal elderly people as the controls. The case group and control group were assessed with the Geriatric Depression Scale （GDS）, Irrational Beliefs Scale （IBS）, and Simple Coping Style Questionnaire （SCSQ） before treatment, and after 6 weeks of treatment, the case group was re-evaluated. Results： Before treatment, the scores of IBS subscales and SCSQ ＂negative coping＂ were all higher in case group than in control group; after treatment, the scores all decreased but still higher than that in the controls （Ps 〈 0. 001 ）. Before treatment, the SCSQ ＂active coping＂ scores were lower in case group than in control group; after treatment, the scores increased but still lower than that in the controls （Ps 〈 0. 001）. Compared to control group, the patients with GDS scores 〈 10 after treatment scored higher in the IBS subscales （Ps 〈 0. 05）, lower in SCSQ ＂active coping＂ （P 〈 0. 001）, and had no difference in SCSQ ＂negative coping＂ scores （P 〉 0. 05）. Before treatment, the GDS score of case group was positively correlated with scores of IBS ＂low frustration tolerance＂ and ＂generalization comment＂ （ r = 0. 59, r = 0. 17; P 〈0. 001 ）, and negatively correlated with the scores of SCSQ ＂active coping＂ （r = -0. 39, P 〈 0. 05）. Conclusion： It suggests that elderly patients with depression have irrational beliefs and negative coping style, and they need psychological intervention to promote rehabilitation and reduce the recurrence of depression.