心理社会干预对难治性抑郁症康复影响的研究

Effect of Psychological and Social Intervention on the Rehabilitation of Treatment-resistant Depression

目的:观察心理社会干预联合文拉法辛与利培酮对难治性抑郁症的疗效和副反应。方法:将符合入组标准的84例患者采用数字随机法分成综合治疗组(心理社会干预联合文拉法辛+利培酮)42例和药物治疗组(文拉法辛+利培酮)42例,于治疗前和治疗第2、4、6、8周末采用汉密尔顿抑郁量表(17项)评定疾病严重程度和疗效,采用不良反应量表评定药物不良反应。结果:综合治疗组总有效率78.57%,药物治疗组总有效率52.38%,两组总有效率比较,差异有统计学意义(字2=6.8,P<0.05)。治疗6、8周末时,综合治疗组汉密尔顿总分分别为(15.37±3.54)、(9.32±3.43)分,药物治疗组汉密尔顿总分(21.23±3.43)、(15.25±3.25)分,两组间同期汉密尔顿总分比较差异有统计学意义(t=2.65、P<0.05,t=2.76、P<0.05),但是在治疗第2、4周末差异无统计学意义(P>0.05)。在不良反应方面,两组比较差异无统计学意义(字2=0.01,P>0.05)。结论:心理社会干预联用药物治疗能提高难治性抑郁治疗效果。

Objective： To explore the efficacy and safety of psychological and social intervention combined with drugs（venlafaxine combined with risperidone）.Method： A total of 84 patients with treatment-resistant depression were randomly（digital random method） divided into comprehensive treatment[psychological and social intervention combined with drugs（venlafaxine combined with risperidone）] group（42 cases） and drugs treatment（venlafaxine combined with risperidone） group（42 cases）.Disease severity and efficacy was assessed with Hamilton Depression Scale（HAMD）, adverse effects with Treatment Emergent Symptom Scale（TESS） at the baseline, 1st weekend, 2nd weekend, 4th weekend and 8th weekend.Result： Effective rate in comprehensive treatment group was 78.57%, in drugs treatment group was 52.38%, there was significant difference in effective rate between the two groups（x2=6.8, P〈0.05）.There was significant difference（t=2.65, P〈0.05, t=2.76, P〈0.05） in score of HAMD between comprehensive treatment group and drugs treatment group at the 6th weekend（15.37 ± 3.54, 21.23 ± 3.43） and 8th weekend （9.32 ±3.43, 15.25 ±3.25）, but there were no significant difference at the 2nd and 4th weekend（P〉0.05）. There was no significant difference（χ2=0.01, P〉0.05） in the adverse drug reactions between two groups.Conclusion： Psychological and social intervention combined with drugs treatment can improve the treatment of refractory depression.