认知行为干预对首发老年抑郁症患者认知功能和社会功能的影响

Effects of cognitive behavioral intervention on cognitive and social functions of first-episode elderly patients with depression

目的:探讨认知行为干预(cognitive behavioral therapy,CBT)对首发老年抑郁症患者认知功能和社会功能的影响。方法:选取2018年10月至2021年5月上海市精神卫生中心老年科收治的98例首发老年抑郁症患者,采用随机数字表法分成对照组与研究组,每组49例。对照组给予抗抑郁药物治疗和精神科基础护理干预,研究组在对照组基础上开展CBT,持续干预6周。干预前后分别采用汉密尔顿抑郁量表-24(Hamilton Depression Scale-24,HAMD-24)、重复性成套神经心理状态测验(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS)、社会功能缺陷筛选量表(Social Dysfunction Screening Scale,SDSS)评价两组抑郁症程度、认知功能和社会功能。结果:与干预前比较,两组干预6周后HAMD-24评分和SDSS评分均明显下降(均P<0.05),RBANS各维度评分和总分均明显升高(均P<0.05),对照组干预前后SDSS评分无显著变化(P>0.05)。与对照组干预6周后比较,研究组HAMD-24评分、SDSS评分更低(P<0.05),注意力、视觉广度、言语功能、即刻和延时记忆评分及RBANS总分均明显较高(均P<0.05)。结论:在抗抑郁药物治疗和常规护理基础上,开展CBT不仅能明显减轻首发老年抑郁症患者的抑郁症程度,而且对认知功能和社会功能也有显著改善效果。

Objective:To explore the effect of cognitive behavioral therapy(CBT)on cognitive and social functions of firstepisode elderly patients with depression.Methods:Ninety-eight patients with first-episode senile depression treated in the Geriatric Department of Shanghai Mental Health Center from October 2018 to May 2021 were selected and randomly divided into a control group and a study group by random number table method,with 49 cases in each group.The control group was given antidepressant treatment and psychiatric basic nursing intervention.The study group underwent CBT on the basis of the control group for 6 weeks.The degree of depression,cognitive function and social function of the two groups were evaluated by Hamilton Depression Rating Scale-24(HAMD-24),Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and Social Disability Screening Schedule(SDSS).Results:Compared with before intervention,HAMD-24 score and SDSS score of the two groups decreased significantly after 6 weeks of intervention(P<0.05),and the scores of each dimension and total score of RBANS increased significantly(P<0.05).There was no significant change in SDSS score of the control group before and after intervention(P>0.05).Compared with the control group after 6 weeks of intervention,the HAMD-24 score and SDSS score of the study group were lower(P<0.05),and the scores of attention,visual span,speech function,immediate and delayed memory and the total score of RBANS were significantly higher(P<0.05).Conclusion:On the basis of antidepressant treatment and routine nursing,CBT can not only significantly reduce the degree of depression in first-episode elderly patients with depression,but also significantly improve cognitive and social functions.