支持性心理治疗在新冠肺炎患者中的应用

Application of supportive psychotherapy among COVID-19 positive patients

目的探讨支持性心理治疗对改善新冠肺炎患者精神心理问题的作用,为新冠肺炎此类突发疫情的早期心理干预提供参考。方法选取2020年2月1日-3月1日在武汉大学人民医院重症监护病房住院治疗的35例新冠肺炎重症患者为研究对象,进行为期2周的支持性心理干预。于干预前和干预2周后,采用匹兹堡睡眠质量指数量表(PSQI)、患者健康问卷抑郁量表(PHQ-9)、广泛性焦虑量表(GAD-7)和社会支持评定量表(SSRS)对患者的睡眠质量、抑郁、焦虑情绪和社会支持水平进行评定。结果检出32例(91.43%)患者存在失眠,31例(88.57%)存在焦虑症状,32例(91.43%)存在抑郁症状,29例(82.86%)表示感受到社会支持不足。干预2周后,患者PSQI、GAD-7和PHQ-9评分均低于干预前(t=5.272、5.475、4.621,P均<0.01),SSRS评分较干预前高(t=-4.639,P<0.01)。干预后,存在失眠、焦虑、抑郁、感受到社会支持不足的患者比例均低于干预前(χ^(2)=18.714、16.232、16.970、4.480,P均<0.01)。结论支持性心理治疗可能有助于改善新冠肺炎患者的焦虑、抑郁情绪和睡眠质量。

Objective To explore the role of supportive psychotherapy in mental health improvement of COVID-19 positive patients,and to provide references for the implementation of early psychological intervention measures in response to the sudden epidemic outburst,such as COVID-19.Methods A total of 35 patients with severe COVID-19 admitted to ICU ward of Wuhan People’s Hospital from February 1 to March 1,2020 were enrolled in this study.All the selected individuals received a 2-week supportive psychotherapy.Then Pittsburgh Sleep Quality Index(PSQI),Patients’Health Questionnaire Depression Scale-9 item(PHQ-9),Generalized Anxiety Disorder Scale(GAD-7)and Social Support Rating Scale(SSRS)were used to evaluate the sleep quality,depression,anxiety and social support of participants at the baseline and the 2^(nd) week of the intervention.Results Insomnia was detected in 32 patients(91.43%),anxiety symptoms in 31(88.57%),depressive symptoms in 32(91.43%),and 29 patients(82.86%)reported feeling a lack of social support.After 2 weeks of intervention,the PSQI,GAD-7 and PHQ-9 scores decreased(t=5.272,5.475,4.621,P<0.01),and SSRS score increased(t=-4.639,P<0.01).After the intervention,the proportion of patients with insomnia,anxiety,depression and lack of social support was also decreased(χ^(2)=18.714,16.232,16.970,4.480,P<0.01).Conclusion Supportive psychotherapy may ameliorate anxiety,depression and sleep quality in COVID-19 patients.