轻症抑郁患者团体认知行为治疗效果的相关因素分析

The correlated influence factors of group cognitive behavioral therapy for mild depression,minor depressive disorder and dysthymia

目的:探讨轻症抑郁(轻性抑郁障碍、恶劣心境以及轻度抑郁症)患者团体认知行为治疗效果的影响因素。方法:采用前瞻性对照设计,将89例轻症抑郁患者在团体认知行为治疗结束后汉密尔顿抑郁量表(HAMD-17)评分<7分列为临床治愈组(n=58例),≥7分列为非临床治愈组(n=31例),采用HAMD-17、汉密尔顿焦虑量表(HAMA)、情感气质自评量表简版(TEMPS-A)评估两组患者临床特征及情感气质类型并进行比较。结果:临床治愈组与非临床治愈组在基线抑郁症状(t=-2.783,P=0.007)、焦虑症状(t=-3.707,P=0.000)和TEMPS-A的循环气质类型(t=-2.470,P=0.016)评分上差异有统计学意义。Logistics回归分析显示,循环气质(B=0.157,Wals=3.872,P=0.049)、基线焦虑症状(B=0.162,Wals=8.659,P=0.003)进入回归方程。结论:情感气质类型中的循环气质和基线焦虑症状可作为影响团体认知行为治疗疗效的预测因素;而诊断类型不同不影响团体认知行为治疗疗效。

Objective：The present study was designed to find out the correlated influence factors of group cognitive behavioral therapy for mild depression,minor depressive disorder and dysthymia. Method：A prospective control study was designed. 89 patients were divided into two group according to the Hamilton de-pression scale（HAMD-17）scores. 58 patients were included in recovery group（HAMD-17 〈 7）and 31 pa-tients were included in non recovery group（HAMD-17≥7）. Scales of HAMD-17,Hamilton anxiety scale（HA-MA）,jane version of the self rating scale（TEMPS-A）were used to evaluate clinical symptoms and related fac-tors. Results：There was significant difference in baseline depressive symptoms（t = - 2. 783,P = 0. 007）, anxiety symptoms（t = - 3. 707,P = 0. 000）and cyclothymic temperament（t = - 2. 470,P = 0. 016）between the two groups. Cyclothymic temperament（B = 0. 157,Wals = 3. 872,P = 0. 049）and baseline anxiety symp-toms（B = 0. 162,Wals = 8. 659,P = 0. 003）entered Logistic regression equation. Conclusion：Cyclothymic temperament and baseline anxiety symptoms can be predictors of group cognitive behavioral therapy for mild de-pression,but different types do not affect the treatment effect.