抗抑郁剂联合内观认知疗法治疗伴有功能性躯体症状的抑郁障碍患者的效果研究

Study on antidepressants combined with Naikan cognitive therapy in treatment of depressive disorder with functional somatic symptoms

目的:探究抗抑郁剂联合内观认知疗法治疗伴有功能性躯体症状的抑郁障碍患者的疗效。方法:将217例伴有功能性躯体症状的抑郁障碍患者随机分为研究组(120例)和对照组(97例),两组均给予5-HT再摄取抑制剂(SSRIs)治疗,研究组在接受2周的药物治疗后给予内观认知疗法。在治疗前、治疗后第4周进行汉密尔顿抑郁量表(HAMD)、躯体症状严重程度量表(PHQ-15)、多伦多述情障碍量表(TAS-20)评估。结果:(1)治疗后研究组的HAMD-17评分(20.86±5.72)明显低于对照组(23.32±5.47);(2)治疗后研究组的TAS-20总分、因子1、因子2、因子3得分明显低于对照组;(3)治疗后研究组的PHQ-15评分(14.62±4.80)明显低于对照组(16.53±4.72)。结论:内观认知疗法能改善伴有功能性躯体症状的抑郁障碍患者的抑郁症状及述情障碍,并能减轻患者躯体症状的感受。

Objective： To explore efficacy of antidepressants combined with Naikan cognitive therapy in treatment of depressive disorders with functional somatic symptoms. Methods： A total of 217 patients with depressive disorders with functional somatic symptoms were randomly divided into study group（ n = 120） and control group（ n = 97）. Both groups were treated with 5-HT reuptake inhibitors（ SSRIs）; besides,the study group received Naikan cognitive therapy after receiving two weeks of drug therapy. The 17-item Hamilton depression scale（ HAMD-17）,patient health questionnaire-15（ PHQ-15） and Toronto alexithymia scale（ TAS-20） were used to evaluate these patients before and 4 weeks after the treatment. Results：（ 1） The HAMD-17 score in the study group was significantly lower than that in the control group after the treatment（ 20.86±5.72 vs. 23.32±5.47）.（ 2） The total score of TAS-20 and the scores of factor 1,factor 2 and factor 3 in the study group was significantly lower than those in the control group after the treatment.（ 3） The score of PHQ-15 in the study group were significantly lower than that in the control group after the treatment（ 14.62±4.80 vs.16.53±4.72）. Conclusions： The Naikan cognitive therapy can improve the depressive symptoms and alexithymia in the patients with depressive disorder with functional somatic symptoms,and can relieve the patients＇ physical symptoms.