短程强化门诊干预项目对双相障碍患者功能水平的影响

The impact of intensive outpatient program on bipolar disorder patients' function

目的:探讨短程强化门诊心理干预项目(intensive outpatient program,IOP)对新近缓解(近4个月有1次急性发作,目前处于缓解期)的双相障碍患者功能的影响。方法:将双相障碍患者按本人意愿分为干预组34例(常规药物治疗合并IOP)和对照组19例(常规药物治疗),干预组进行为期4周共10次IOP干预,对照组仅接受常规药物治疗。使用席汉残疾量表(SDS)和大体功能量表(GAF)分别在基线、治疗结束和3个月末随访评估患者功能水平,使用重复测量方差分析进行统计并对两组进行比较。结果:两组SDS和GAF评分在基线、治疗结束和3个月末随访时组间比较,差异无统计学意义(t=-0.05~1.57,P均>0.05)。重复测量方差显示,仅SDS家庭生活、效率低下天数和GAF时间主效应显著[F(2,44)=5.93,P=0.005;F(2,46)=5.05,P=0.01;F(2,48)=91.48,P<0.001],其余均不显著。结论:短程IOP对新近缓解双相障碍患者的功能改善不显著,有待延长随访期进一步评估其长期影响。

Objective： To explore the impact of intensive outpatient program（ IOP） on the function of patients with bipolar disorder who had one acute mood episode within 4 months but got remission now. Method：Nineteen patients were distributed into control group（ treat as usual,TAU） and 34 patients were signed into intervention group（ TAU plus IOP） according to their preference. Patients in intervention group received 10 sessions of IOP intervention within 4 weeks,while control group only received medication therapy as usual. Sheehan disability scale（ SDS） and global assessment of functioning scale（ GAF） were used to assess the function of patients with bipolar disorder at baseline,after treatment and follow-up for 3 months after treatment. Repetitive measure analysis of variance（ ANOVA） was used for data analysis. Results： There were no significant differences of functional levels between intervention group and control group in SDS and GAF neither at baseline,after treatment or follow-up for 3 months after treatment（ t =-0. 05 - 1. 57,all of P〉0. 05）. Results of repeated ANOVA showed that only main effect of time was significant in sub-scale of family life/home responsibilities and days under productive in SDS,and GAF（ F（ 2,44） =5. 93,P =0. 005; F（ 2,46） =5. 05,P =0. 01; F（ 2,48） =91. 48,P〈0. 001）.Conclusion： The impact of IOP on the function of patients with bipolar disorder who got remission recently was not significant in short-term follow-up. Prolonged follow-up was needed to determine the long-term effect.