短程团体认知行为治疗个体认知行为治疗联合艾斯西酞普兰与单用艾斯西酞普兰治疗老年抑郁症120例临床疗效分析

Comparison analysis of the clinical effect of short-term group cognitive behavioral therapy combined with escitalopram,individual cognitive behavioral therapy combined with escitalopram and single escitalopram treatment in 120 cases of elderly patients wit

目的研究短程团体认知行为治疗、个体认知行为治疗联合艾斯西酞普兰与单用艾斯西酞普兰治疗对于住院老年抑郁症患者的疗效,以及改善社会功能的效果。方法把符合国际精神障碍诊断和统计手册(ICD)-10抑郁症诊断标准的120例老年患者按随机数字表法,分成对照组、研究1组[短程团体认知行为治疗组(SGCBT)]和研究2组[个体认知行为治疗组(CBT)],每组40例。对照组仅使用艾斯西酞普兰,研究1组使用SGCBT联合艾斯西酞普兰,研究2组采用CBT联合艾斯西酞普兰,共观察8周,使用老年抑郁量表(GDS)以及汉密尔顿抑郁量表(HAMD)进行疗效比较。结果8周后,3组的治疗均有效,其中研究1、2组与对照组的HAMD和GDS评分均有显著下降,差异具有统计学意义(P<0.01);SGCBT组在第2周较CBT组HAMD的减分较低,第3~8周差异有统计学意义(P<0.01)。结论对老年住院抑郁症患者,认知行为治疗联合药物治疗方法较单纯的药物治疗效果更佳,其中SGCBT比CBT起效更快,疗效更好。

Objective To analysis the clinical effect and social function improvement of short--term group cognitive behavioral therapy combined with escitalopram, individual cognitive behavioral therapy combined with escitalopram and single escitalopram treatment in elderly inpatients with depression. Methods One hundred and twenty elderly inpatients who met the diagnostic criteria of depression in ICD-10 were randomized into control group, study group 1 （short-term group cognitive behavioral therapy group, SGCBT Group） and study group 2 （individual cognitive behavioral therapy, CBT Group）. 40 patients were in each group. All patients accepted es- citalopram, study group 1 combined with SGCBT, and study group 2 combined with CBT for 8 weeks. The geriat- ric depression scale （GDS） and Hamilton depression rating scale （HAMD） were used to evaluate the clinical effect. Results Eight weeks later, all of the 3 groups have effect. Study group 1 and 2 were significantly lower in HAMD and GDS score compared with control group （P〈0.01）. Comparing with CBT Group, SGCBT group had a significant reduction in HAMD score at the 2nd week, and form the 3td to 8th week, it showed a significant difference （P〈0.01）. Conclusion Compared with single drug treatment, cognitive behavioral therapy combined with drug showed a better clinical effect in elderly inpatient with depression. SGCBT had a faster and stronger effect than CBT. Therefore, SGCBT is worth prompting for elderly inpatient with depression.