认知行为疗法在强迫症患者中的应用价值

Application Value of Cognitive Behavioral Therapy in Patients with Obsessive-compulsive Disorder

目的观察认知行为疗法在强迫症患者中的应用价值。方法选取河南省洛阳荣康医院2018年4月至2020年5月收治的86例强迫症患者,按照随机数表法分为观察组、对照组,各43例。在常规干预的同时,给予对照组患者舍曲林治疗,观察组在对照组基础上联合认知行为疗法,两组均治疗6个月。比较两组疗效、耶鲁-布朗强迫症状量表(Y-BOCS)评分、医学应对方式问卷(MCMQ)评分、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分及不良反应发生率。结果治疗后观察组治疗总有效率[95.35%(41/43)]高于对照组[81.39%(35/43)](P<0.05)。治疗1、2、4、6个月后,观察组Y-BOCS总评分、强迫思维评分、强迫行为评分低于对照组(P<0.05)。观察组MCMQ问卷中屈服、回避评分低于对照组(P<0.05),面对评分高于对照组(P<0.05)。观察组WHOQOL-BREF评分高于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论在舍曲林基础上增加认知行为疗法,对强迫症患者疗效较好,可有效缓解患者强迫症状,调节其应对方式,提高其生活质量。

Objective To observe the application value of cognitive behavioral therapy in patients with obsessive-compulsive disorder.Methods A total of 86 patients with obsessive-compulsive disorder admitted to Luoyang Rongkang Hospital of Henan Province from April 2018 to May 2020 were selected and divided into observation group and control group according to the random number table method,with 43 cases in each.At the same time of routine intervention,the control group was given sertraline treatment,and the observation group was combined with cognitive behavioral therapy on the basis of the control group.Both groups were treated for 6 months.The curative effect,Yale-Brown obsessive-compulsive symptom scale(Y-BOCS)score,medical coping mode questionnaire(MCMQ)score,World Health Organization quality of life short form(WHO Q0L-BREF)score and the incidence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate of the observation group[95.35%(41/43)]was higher than that of the control group[81.39%(35/43)](P<0.05).After 1,2,4 and 6 months of treatment,the Y-BOCS total score,obsessive thinking score and obsessive behavior score in the observation group were lower than those in the control group(P<0.05).The yield and avoidance scores in the MCMQ questionnaire of the observation group were lower than those of the control group(P<0.05),and the confrontation score was higher than that of the control group(P<0.05).The WHO QOL-BREF score in the observation group was higher than that in the control group(P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The addition of cognitive behavioral therapy on the basis of sertraline has a good effect on patients with obsessive-compulsive disorder,which can effectively relieve the obsessive-compulsive symptoms,adjust their coping style,and improve their quality of life.