团体心理治疗对躯体形式障碍患者的影响

Effect of group psychotherapy on somatoform disorders

目的探讨团队心理治疗对躯体形式障碍患者早期干预的疗效。方法选取2014年10月-2015年1月海南省儋州市农垦那大医院收治的躯体形式障碍患者97例,依据随机数表法分为A组(团体心理治疗32例)、B组(药物治疗33例)、C组(团队心理治疗+药物治疗32例),比较3组患者的临床疗效和躯体形式症状筛查量表(SOMS-7)、大体评定量表(GAS)及汉密尔顿抑郁量表(HAMD)评分。结果 A组显效率为62.50%,好转率为81.25%;B组显效率为63.64%,好转率为84.85%;C组显效率为87.50%,好转率为96.88%,组间比较,差异有统计学意义(P<0.05),C组患者的显效率和好转率高于A、B组。治疗前,3组患者的SOMS-7评分比较,差异无统计学意义(P>0.05)。治疗后48周,A组、B组及C组的SOMS-7评分为(10.44±2.17)、(10.72±2.11)和(6.75±2.09)分,经方差分析,差异有统计学意义(P<0.05)。C组的SOMS-7评分低于A、B组。治疗前,3组患者的GAS评分比较,差异无统计学意义(P>0.05)。治疗后48周,A组、B组及C组的GAS评分为(76.18±5.44)、(77.29±5.19)和(84.25±5.91)分,经F检验,差异有统计学意义(P<0.05)。C组的GAS评分高于A、B组。3组患者的HAMD评分比较,差异无统计学意义(P>0.05)。治疗后48周3组患者的HAMD评分比较,差异有统计学意义(P<0.05),C组患者的HAMD评分低于A、B组。结论团体心理治疗联合药物使用在治疗躯体形式障碍方面成效好,能够改善患者精神状况及临床症状。

Objective To evaluate the efficacy of team psychotherapy for early intervention of somatoform disorders. Methods According to a random number, 97 patients with somatoform disorders treated in Danzhou Agricultural Reclamation Nada Hospital from October 2014 to January 2015 were assigned into group A（32 cases who received team psychotherapy）, group B（33 cases who received medication） and group C（32 cases who received both team psychotherapy and medication）. The clinical efficacy, Somatoform Symptoms Screening Scale（Chinese version SOMS-7） score, Global Assessment Scale（GAS） score and Hamilton Depression Scale（HAMD） score were campared among the three groups. Results In the group A, the effective rate was62.50%, the improvement rate was 81.25%; in the group B, the effective rate was 63.64%, the improvement rate was 84.85%; in the group C, the effective rate was 87.50%, the improvement rate was 96.88%, the effective rate and the improvement rate of the group C were higher than those of the groups A and B（P〈0.05）. Before treatment, there were no significant differences in the SOMS-7 score among the three groups（P〉0.05）. In the 48 th week after treatment, the SOMS-7 score of the groups A, B and C was（10.44 ± 2.17）,（10.72 ± 2.11） and（6.75 ± 2.09） respectively; the SOMS-7 score of the group C was lower than that of the group A and the group B（P〈0.05）. Before treatment, there were no significant differences in the GAS score among the three groups（P〉0.05）. In the 48 th week after treatment, the GAS score of the groups A, B and C was（76.18 ± 5.44）,（77.29 ± 5.19） and（84.25 ± 5.91） respectively; the GAS score of the group C was higher than that of the group A and the group B（P〈0.05）. There were no significant differences in the HAMD score among the three groups before treatment（P〉0.05）. The HAMD score in the group C was lower than that in the group A and the group B（P〈0.05）, and the differences were statistically significant（P〈0.05）.Conclusions Combined use of group psychotherapy and drug has achieved remarkable success in the treatment of somatoform disorders, and can significantly improve patients＇ mental health and clinical symptoms.