团体现实疗法对首发轻中度广泛性焦虑障碍患者的疗效

Effects of Group Reality Therapy on First Episode of Generalized Anxiety Disorders

目的:探讨团体现实疗法对首发轻中度广泛性焦虑障碍(GAD)患者的疗效。方法:采用前瞻性对照研究方法,将69名GAD患者随机分为治疗组和对照组,治疗组参加8周团体现实疗法治疗,两组在基线与8周后分别测评汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、内控性、有势力的他人及机遇量表(IPCS)、应付方式问卷、自尊量表(SES)和幸福感指数;此外,治疗组在第2、4、6周复测HAMA。结果:8周后治疗组HAMA总分和分量表分均明显低于对照组(P<0.01));"内控性"、应付方式中"解决问题"和"求助"、SES及幸福感指数评分均显著高于对照组,"有势力的他人"、"退避"评分显著低于对照组(P<0.05)。与基线评分相比,治疗组HAMA总分和精神性焦虑从第2周显著减低(P<0.05),躯体性焦虑从第4周显著降低(P<0.05)。结论:团体现实疗法对轻中度GAD患者的焦虑症状疗效显著,精神焦虑改善早于躯体焦虑症状,患者内控力、积极应对方式的应用、自尊和幸福感均提高。

Objective： To explore the effects of group reality therapy for the first episode patients with mild to moderate generalized anxiety disorder（GAD）. Methods： Sixty-nine patients with first-onset mild to moderate GAD were randomly di- vided into the therapy group and the control group. The therapy group attended group reality therapy for 8 weeks, all the par- ticipants were measured at baseline and 8 weeks later respectively using Hamilton anxiety Scale（HAMA）, Hamilton depres- sion Scale（HAMD）, Internality, Powerful Others and Chance Scale（IPCS）, Coping Style Questionnaire, self-esteem Scale （SES）, and well-being index. All the participants were tested by HAMA in the second, fourth, sixth week respectively. Re- sults： Compared with the scores of the two groups after $ weeks, the scores of HAMA and psychiatric anxiety and somatic anxiety were significantly lower than the control group（P〈O.O1）; the internality score of 1PCS, the solving problem and seek- ing help scores of Coping Style Questionnaire, SES and well-being scores of the therapy group were significantly higher than the control group（P〈O.05）, while the Powerful Others score of IPCS, the withdrawal score of Coping Style Questionnaire of the therapy group were significantly lower than the control group（P〈0.05）, The scores of HAMA and psychogenic anxiety decreased significantly from the second week（P〈O.05）, while somatic anxiety score decreased significantly from the fourth week（P〈O.05）. Conclusion： Group reality therapy is effective for the treatment of anxiety symptoms in patients with mild to moderate GAD. The development of psychogenic anxiety is earlier than somatic anxiety. After treatment, the internal control ability of the patient improved, and they adopt more positive coping style, and their self-esteem and happiness ＆ life satis- faction also increase.