基于认知行为疗法的自助干预对门诊首发抑郁症患者心理健康水平影响的研究

Effect of a cognitive behavioral self-help intervention on depressive symptoms and mental health status of firstepisode depression outpatients

目的:评价基于认知行为疗法的自助干预对改善门诊首发抑郁症患者抑郁症状与心理健康水平的效果。方法:将126名门诊首发抑郁症患者随机分成无指导的干预组(n=42)、有指导的干预组(n=42)和对照组(n=42),干预中及干预结束后共失访25人,最终入组的无指导的干预组39人,有指导的干预组32人,对照组30人。无指导的干预组接受自助手册形式的自助干预,有指导的干预组接受自助手册加上电话形式的自助干预,对照组不接受自助干预。所有被试对象在干预前(入组时)、后(2个月)自评完成贝克抑郁自评问卷(BDI)、凯斯勒心理困扰量表(K10)。结果:干预后,两个干预组和对照组BDI总分、K10总分均较干预前下降(P<0.05);但组间差异无统计学意义(P>0.05)。结论:基于认知行为疗法的自助干预不足以对改善首发抑郁症患者的抑郁症状和心理健康状况起到明显作用,建议今后在设计类似的干预研究时,可以加强干预强度,以增强干预的效果。

Objective： To explore the effect of self-help intervention based on Cognitive Behavioral Therapy on depressive symptoms and mental health status of first-episode depression outpatients. Methods： We randomly divided 126 first-episode depression outpatients from two tertiary hospitals in Changsha into the no-guided experimental group （n=42） ,the guided experimental group （n=42） and the control group （n=42）. During and after the intervention, 25 subjects were lost to follow-up, Finally, there were 39 subjects in the no-guided experimental group, 32 in the guided experimental group and 30 in the control group. An antidepressant skills workbook was provided for each patient in the non-guided experimental group, besides, one telephone guidence every two weeks was provided for each patient in the guided experimental group, while no specific training was supplied to the control group. We evaluated all subjects with Beck Depression Inventory （BDI） and 10-item Kessler Scale （K10） before the self-help intervention and 2 months after the intervention. Results： After the intervention, the scores of both BDI and K10 in three groups decreased significantly （P〈0.05）. There was no significant change after the intervention in the scores of BDI and K10 between the experimental group and the control group （P〉0.05）. Conclusions： The cognitive behavioral self-help intervention by self-help manual could not effectively improve depressive symptoms and mental health status of first-episode depression outpatients. We suggest that intensity of intervention should be strengthened in future study.