摘要
目的:通过随机对照研究,分析评价认知行为治疗(CBT)对强迫障碍(OCD)患者药物治疗依从性的影响。方法:对分别接受5-羟色胺再摄取抑制剂(SSRIs)治疗(简称药物治疗组)或SSRIs联合CBT组(简称联合治疗组)的80例门诊OCD患者的药物治疗依从性进行随访研究。按照治疗方案随机分为SSRIs组(40例)和SSRIs联合CBT组(40例),被试在24周之前终止药物治疗则定义为脱落;基线时Y-BOCS的评分大于24分,则定义为高分组,反之则是低分组。结果:联合治疗组的脱落率为15%(6/40),药物治疗组的脱落率为40%(16/40),差异具有统计学意义(χ2=6.270,P<0.05);基线时Y-BOCS低分组的脱落率为36.4%(16/44),Y-BOCS高分组脱落率为16.7%(6/36),差异具有统计学意义(χ2=3.853,P<0.05);24周末完成组和脱落组Y-BOCS第4周末减分率分别为(14.62%±27.96%)和(4.42%±9.56%),差异具有统计学意义(t=-2.43,P<0.05)。回归分析结果显示:药物治疗脱落的发生和治疗的方案相关,药物治疗时联合运用CBT可降低脱落率(OR=0.279,95%CI(0.092,0.848)),有助于提高OCD患者药物治疗的依从性。结论:相对于单纯药物治疗,药物联合CBT治疗能够显著提高OCD患者的服药依从性,使患者从随后的治疗中获得更多的收获,减少症状反复。
Objective: To evaluate the drug compliance between the group of 5-selective serotonin reuptake inhibitor (SSRIs) treatment and the group of SSRIs combining cognitive-behavioral therapy(CBT) for obsessive-compulsive disorder (OCD). Methods: 80 patients met the DSM-IV criteria for OCD were randomly assigned to group of SSRIs(n=40) and com- bined therapy group(n=40). The basic demographic data, the score of Y-BOCS and HAMA at base line and the score-reduc- ing rate of Y-BOCS at the 4th week of the study were analyzed to learn the influence the medicine-taking compliance by Bi- nary Logistic Analysis. The drop out was defined as that the patient discontinued the drug at the 24th week. At baseline, the participants with Y-BOCS score greater than 24 was defined as the high score group, whereas those with lower than or equal to 24 was low score group. Results: The dropout rate of the combined treatment group was 15%(6/40). The rate of drop out in the SSRIs group was 40%(16/40). And the difference was statistically significant(x2=6.270, P〈0.05). The drop- out rate of the low and high score group were 36.4%(16/44) and 16.7%(6/36) respectively. And the difference is statistically significant(x2=3.853, P〈0.05). The score-reducing rate of Y-BOCS at the 4th week in the completer and drop out group were respectively(14.62%±27.96%) and(4.42%±9.56%), which showed significant difference(t=-2.43,P〈0.05). Regression analysis showed whether the combination of CBT is an important factor affecting the adherence of the drug[OR=0.279, 95% CI(0.092, 0.848)]. Conclusion: Drug combination CBT can significantly improve the medication compliance of patients with OCD and have the patient get long-term benefits which maybe reduce recurrence.
出处
《中国临床心理学杂志》
CSSCI
CSCD
北大核心
2018年第1期175-178,169,共5页
Chinese Journal of Clinical Psychology
基金
国家科技支撑计划课题:神经症早期识别与治疗方案优化研究(2007BA117801)
国家科技支撑计划:常见心理疾患认知行为治疗技术规范及示范模式建设(2009BA177811)
关键词
认知行为治疗
强迫障碍
服药依从性
Obsessive-compulsive disorder
Cognitive behavior therapy
Medication compliance