双相情感障碍患者团体支持性干预后复发率对照研究

A comparative study on recurrence rate of bipolar disorder patients after supportive group intervention

目的研究团体支持性干预对双相情感障碍患者复发率的影响。方法选取2017年6月至2018年6月湖北科技学院附属第二医院精神科收治的80例双相情感障碍患者作为研究对象,按照随机数表法分为对照组和实验组各40例,对照组进行药物治疗,实验组在药物治疗同时进行团体支持性干预等心理康复干预,治疗12周。于治疗前后分别采用家庭关怀度指数问卷(APGAR)、汉密尔顿抑郁量表17版本(HAMD-17)、杨氏躁狂评定量表(YMRS)、社会功能缺陷量表(SDSS)和功能检测简版(FAST)对两组患者的家庭环境、精神状态、应对能力、社会功能、总体认知受损进行评定并做统计学分析。结果为期12周团体支持性干预后,实验组患者的APGAR评分为(16.82±2.46)分,明显高于对照组的(6.78±3.76)分,HAMD-17评分为(11.72±2.15)分,明显低于对照组的(20.56±3.56)分,YMRS评分为(16.80±3.45)分,明显低于对照组的(33.17±6.55)分,差异均有统计学意义(P<0.05);实验组SDSS总评分为(6.47±4.82)分,明显低于对照组的(12.25±7.13)分,差异有统计学意义(P<0.05)。在FAST各项因子和总分上,实验组自主生活[(2.92±1.81)分]明显低于对照组[(7.16±1.78)分],职业功能[(6.94±3.35)分]明显低于对照组[(10.27±3.46)分],认知功能[(1.67±1.98)分]明显低于对照组[(11.54±3.12)分],钱财管理[(1.64±0.53)分]明显低于对照组[(3.43±1.97)分],人际关系[(5.08±4.64)分]明显低于对照组[(10.89±3.71)分],休闲[(1.42±1.83)分]明显低于对照组[(5.93±1.75)分],总分[(25.87±11.26)分]明显低于对照组[(46.22±14.14)分],差异均有统计学意义(P<0.05)。结论团体支持性干预能够促进患者控制自己情绪,改善家庭与社会功能,显著降低复发率、提高服药依从性,回归社会。

Objective To study the effect of supportive group intervention on the recurrence rate of bipolar disorder patients. Methods From June 2017 to June 2018, 80 patients with bipolar affective disorder were selected as the study subjects. They were divided into the control group and experimental group according to random number table method. The control group was treated with drugs, while the experimental group was treated with supportive group intervention and other psychological rehabilitation interventions for 12 weeks. Before and after treatment, family APGAR(adaptation, partnership, growth, affection, resolve) index, Hamilton Depression Scale 17(HAMD-17), Young’s Mania Rating Scale(YMRS), Social Deficiency Scale(SDSS), and Function Testing Simple Version(FAST) were used to assess the family environment, mental state, coping ability, social function and general cognitive impairment of the two groups. Results After 12 weeks of supportive group intervention, the APAR score of the experimental group was16.82±2.46, which was significantly higher than 6.78±3.76 of the control group;the HAMD-17 score was 11.72±2.15,which was significantly lower than 20.56±3.56 of the control group;the YMRS score was 16.80±3.45, which was significantly lower than 33.17±6.55 of the control group(all, P<0.05). The total score of SDSS was 6.47±4.82, which was significantly lower than 12.25 ± 7.13 of the control group(P<0.05). In terms of the factors and total scores of FAST, the scores of autonomous life, occupational function, cognitive function, money management, interpersonal relationship, leisure in the experimental group were 2.92±1.81, 6.94±3.35, 1.67±1.98, 1.64±0.53, 5.08±4.64, 1.42±1.83, respectively,which were significantly lower than corresponding 7.16±1.78, 10.27±3.46, 11.54±3.12, 3.43±1.97, 10.89±3.71, 5.93±1.75 in the control group(all, P<0.05), and the total score of FAST was 25.87±11.26, which also was significantly lower than 46.22 ± 14.14 of the control group(P<0.05). Conclusion Supportive group intervention can promote patients to control their emotions, improve family and social functions, significantly reduce the recurrence rate, improve drug compliance, and return to society.