简化认知行为治疗对广泛性焦虑的疗效初步研究

Preliminary study on effect of simplified cognitive behavior therapy on generalized anxiety

目的通过对照试验初步验证简化认知行为治疗(SCBT)的临床疗效,建立针对广泛性焦虑的适宜技术。方法在心理咨询门诊通过海报宣传、护士推荐等方式招募广泛性焦虑患者,采用对照、盲法评估的方法分为SCBT组、SCBT+药物组和常规治疗组。采用广泛性焦虑量表(GAD-7)、14项汉密尔顿焦虑量表(HAMA-14)和17项汉密尔顿抑郁量表(HAMD-17)评估患者焦虑抑郁状况的变化。结果总样本40例,平均年龄为(34.30±9.55)岁,文化程度在大学本科及以上的31例(77.50%)。治疗8周末抑郁情绪有所改善,3组间差异无统计学意义(F=2.615,P=0.087)。基线时,3组间GAD-7评分的差异无统计学意义(P=0.195);8周末时,仅SCBT组减分率达50%以上(P=0.486)。基线时,3组间HAMA-14评分的差异有统计学意义(P=0.008);2周末时,3组有效进步例数分别为11、11、9例;8周末时,3组减分率分别为53.50%、54.79%、39.75%(P=0.317);治愈例数分别为7、6、2例。结论 SCBT疗效与SCBT联合药物治疗的效果相当,优于常规治疗;SCBT技术可行性高,对国内GAD患者有效性较强,长期疗效较好。

Objective To identify appropriate technologies for generalized anxiety disorder （GAD） by preliminarily verifying the clinical curative effect of simplified cognitive behavioral therapy （SCBT） through a controlled trial. Methods Patients with GAD were enrolled by poster propaganda and recommendation by nurses in the psychological consultation clinic. Patients were divided into the SCBT group, SCBT ＋ drug group, and routine treatment group by controlled trial and blind assessment. Changes of anxiety and depression of patients were assessed by generalized anxiety scale （GAD-7）, Hamilton anxiety scale of 14 items （HAMA-14）, and Hamilton depression scale of 17 items （HAMD-17）. Results A total of 40 patients were enrolled. The average age was 34. 30 ＋9.55 and 31 （77.50%） of them owned a university degree or above. The depressive symptom was alleviated after 8 weeks of treatment and the differences of three groups were not statistically significant （F=2. 615, P=0. 087）. The differences of GAD-7 of three groups were not statistically significant at baseline （P=0. 195）. Only the reduction rate of SCBT group was larger than 50% after 8 weeks （P=0. 486）. The differences of HAMA-14 of three groups were statistically significant at baseline （P = 0. 008）. For three groups, 11, 11, and 9 cases were effectively alleviated after 2 weeks. Reduction rates of three groups after 8 weeks were 53.50%, 54.79%, and 39.75% and numbers of cured cases of three groups were 7, 6, and 2, respectively. Conclusion The curative effect of SCBT is equal to that of SCBT combined with drug and better than that of routine treatment. SCBT is feasible and effective for domestic GAD patients and the long-term curative effect is ideal.