非结构式团体心理治疗在双相情感障碍中的应用

Application of unstructured group psychotherapy in bipolar disorder

目的探讨非结构式团体心理治疗在双相情感障碍中的实际应用情况。方法选取双相情感障碍患者40例,按随机数字法分成观察组和对照组,各组20例。对照组患者均给予心境稳定剂等药物治疗,观察组在对照组基础上辅以非结构式团体心理干预。采用贝克-拉范森躁狂量表(BRMS)、汉密尔顿抑郁量表(HRSD)、生活质量测评量表(WHOQOL-100)和Morisky服药依从性量表-8(MMAS-8)分别评估两组患者躁狂症状、抑郁状态、生活质量及服药依从性并进行比较。结果干预后,两组患者BRMS评分和HRSD评分中的焦虑/躯体化、体质量、认识障碍、日夜变化、迟缓、睡眠障碍、绝望感及总分均较干预前降低,MMAS-8评分和WHOQOL-100评分中的生理、心理、独立性、社会关系、环境、精神/宗教/信仰等6个领域评分和总评分较干预前升高,差异有统计学意义(t分别=10.58、6.58、10.53、9.47、9.79、8.24、10.04、7.45、11.07、9.95、6.69、4.35、5.08、3.24、7.24、4.28、7.04、6.20、11.50、5.21、3.82、5.21、9.60、3.78、4.32、6.54、6.28、2.03、3.70、4.09、2.15、2.42、2.52、4.81,P均<0.05)。且观察组患者干预后BRMS评分和HRSD评分中的焦虑/躯体化、体质量、认识障碍、日夜变化、迟缓、睡眠障碍、绝望感及总分明显低于对照组干预后,MMAS-8评分和WHOQOL-100评分中的生理、心理、独立性、社会关系、环境、精神/宗教/信仰等6个领域评分和总评分明显高于对照组干预后,差异有统计学意义(t分别=4.19、6.20、6.32、5.18、6.57、3.59、3.89、4.88、5.72、6.48、2.98、2.73、4.25、2.59、2.58、4.05、2.97,P均<0.05)。结论双相情感障碍患者在药物治疗过程中辅以非结构式团体心理治疗,能有效改善患者的躁狂症状和抑郁状态,提高患者的服药依从性及生活质量。

Objective To explore the practical application of unstructured group psychotherapy in bipolar disorder.Methods Totally 40 patients with bipolar disorder were randomly divided into observation group and control group with20 cases in each group.The patients in control group were treated with mood stabilizers drugs.The observation group was supplemented with non-structural group psychological intervention on the basis of drug treatment.Manic symptoms,depressive state,quality of life and drug compliance were assessed with the Baker-Lavanson mania scale(BRMS),the hamilton depression scale(HRSD),the quality of life scale(WHOQOL-100)and the Morisky medication adherence scale(MMAS-8).Results After intervention,the BRMS score,anxiety/somatization,body mass,cognitive impairment,day and night changes,retardation,sleep disorder,despair and total score of the two groups were lower than those before intervention,while the MMAS-8 score,physical,psychological,independence,social relations,environment,spirit/religion/belief score and total score were higher than those before intervention(t=10.58,6.58,10.53,9.47,9.79,8.24,10.04,7.45,11.07,9.95,6.69,4.35,5.08,3.24,7.24,4.28,7.04,11.50,5.21 3.82,5.21,9.60,3.78,4.32,6.54,6.28,2.03,3.70,4.09,2.15,2.52,4.81,P<0.05).After intervention,the scores of BRMS,anxiety/somatization,body mass,cognitive impairment,day and night change,retardation,sleep disorder,despair and total score in the observation group were significantly lower than those in the control group,while the scores of MMAS-8,physiology,psychology,independence,social relations,environment,spirit/religion/belief and total score were significantly higher than those of the control group(t=4.19,6.20,6.32,5.18,6.57,3.59,3.89,4.88,5.72,6.48,2.98,2.73,4.25,2.59,2.58,4.05,2.97,P<0.05). Conclusion Non-structural group psychotherapy can effectively improve the manic symptoms and depression of patients with bipolar affective disorder,and improve their medication compliance and quality of life.