计算机化认知行为治疗干预孕早期抑郁障碍效果的研究

Effect of computerized cognitive behavior therapy on early pregnancy depression

目的:探讨计算机化认知行为治疗(CCBT)对孕早期抑郁障碍患者的干预效果。方法:招募南京市妇幼保健医院就诊建卡并诊断为抑郁障碍的孕早期女性60例,随机分为CCBT组和对照组,每组30例。CCBT组每天登陆CCBT网站完成治疗,对照组每周进行2次心理健康宣教;均为30 d。以治疗有效率及产后抑郁发生率为主要结局指标,以爱丁堡产后抑郁量表(EPDS)、抑郁症快速自评量表(QIDS-SR16)、简明幸福与生活质量满意度问卷(Q-LES-Q-SF)评分及精神专科转诊率为次要结局指标评估CCBT的疗效。结果:治疗后CCBT组有效率(73.33%)明显好于对照组(23.33%)(P<0.01);产后抑郁发生率(36.67%)明显低于对照组(83.33%)(P<0.01);建议转诊精神专科的几率(16.67%)明显低于对照组(43.33%)(P<0.05);干预后CCBT组EPDS、QIDS-SR16评分显著低于对照组(P均<0.01),两组间Q-LES-Q-SF评分差异无统计学意义(P=0.447)。结论:CCBT干预能有效缓解孕早期抑郁障碍患者的抑郁症状,降低产后抑郁障碍的发生风险。

Objective:To evaluate the efficacy of computerized cognitive behavioral therapy(CCBT)in patients with early pregnancy depression.Method:60 cases of early pregnancy depression were recruited in Nanjing Maternal and Child Health Care Hospital.The patients were randomly divided into two groups,30 patients in CCBT group and 30 patients in control group.The CCBT group received CCBT treatment,logging into the system once a day for 30 days.The control group received conventional mental health education,twice a week for 30 days.The effective rate of treatment and the incidence of postpartum depression were the main indicators of outcomes,Edinburgh Postnatal Depression Scale(EPDS),16 item Quick Inventory of Depressive Symptomatology-self Report(QIDS-SR16),Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form(Q-LES-Q-SF)scores and the rate of psychiatric referrals were set as the secondary indicators of outcomes to evaluate the efficacy of CCBT treatment.Results:The effective rate of CCBT group(73.33%)was significantly better than that of control group(23.33%)(P<0.01).The incidence of postpartum depression(36.67%)was significantly lower than that of the control group(83.33%)(P<0.01).The risk of referral to psychiatric specialty(16.67%)was significantly lower than that of the control group(43.33%)(P<0.05).After the intervention,the scores of EPDS and QIDS-SR1 were significantly lower than those of the control group(all P<0.01).There was no statistically significant difference between the two groups in Q-LES-Q-SF score(P=0.447).Conclusion:CCBT treatment can effectively relieve depressive symptoms in patients with early pregnancy depression and reduce the incidence of postpartum depression.