团体认知行为治疗对伴发焦虑抑郁的糖尿病患者的疗效

Efficacy of group cognitive-behavioral therapy for diabetic patients with anxiety and depression

【目的】探讨团体认知行为治疗对伴发焦虑抑郁的糖尿病患者的疗效。【方法】采用随机双盲对照试验,选取上海市奉贤区内伴有焦虑抑郁情绪的糖尿病患者42例,分别接受10周的团体认知行为治疗(GCBT)或仅糖尿病健康教育。治疗前后分别采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、席汉残疾量表(SDS)对两组患者进行评估并检测空腹血糖等疗效指标。【结果】10周干预结束后,两组被试间空腹血糖值的差异无统计学意义,治疗后两组HAMD、HAMA、SDS评分明显下降,治疗前后两组评分的差异具有统计学意义(F分别为6.801、10.30、5.02,P分别为0.013、0.003、0.031),实验组治疗前后HAMD差值与病程、学历负相关(r分别为-0.486、-0.541,P分别为0.030、0.014),而SDS差值与性别差异显著相关,女性SDS评分下降更显著(r=0.582,P=0.007)。【结论】团体认知行为治疗有助于改善伴发焦虑抑郁的糖尿病患者的情绪,有利于恢复社会功能和提高生活质量。

[Objective]To explore the efficacy of group cognitive-behavioral therapy(GCBT)for diabetic patients with anxiety and depression.[Methods]In this randomized control study,42 patients was recruited for treatment of diabetes and allocated them in a randomized manner(1∶1)into two groups to receive either 10-weeks GCBT plus regular education or regular education alone.Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Self-rating Depression Scale(SDS),and fasting blood glucose were measured and evaluated before and after treatment.[Results]After 10 weeks of intervention,the total scores of HAMD,HAMA,and SDS were significantly decreased.Compared with the control group,repeated measures of ANOVA revealed a significant group-by-time interaction(F=6.801,10.30,5.02,P=0.013,0.003,0.031).The difference of HAMD was negatively correlated with disease duration and education(r=-0.486,-0.541,P=0.030,0.014),and the difference of SDS was obviously correlated with gender,as the SDS score of women decreased more significantly(r=0.582,P=0.007).[Conclusion]Group cognitive-behavioral therapy can help to improve the mood of diabetic patients with anxiety and depression,rehabilitating their social function and life quality.