综合干预模式对门诊广泛性焦虑障碍患者的疗效

Effect of comprehensive intervention on outpatients with generalized anxiety disorder

目的:探讨综合干预模式对门诊广泛性焦虑障碍(GAD)患者的疗效。方法:采用随机数字表法将92例GAD门诊患者分为干预组(n=45)和对照组(n=47),两组均给予门诊常规药物治疗,干预组同时合并综合干预(包括团体认知行为治疗及诊室外疾病管理),疗程12周。分别在干预前、干预1个月、干预结束时、干预结束后1个月随访时采用症状自评量表(SCL-90)、总体幸福感量表(GWB)、简易应对方式问卷(SCSQ)、一般自我效能感量表(GSES)对两组患者进行评估。结果:干预1个月时两组SCL-90总分、躯体化、抑郁、焦虑因子分以及GWB中对健康担心维度评分差异有统计学意义(P<0.05或P<0.01);干预完成及随访时两组SCL-90总分、躯体化、抑郁、焦虑因子分以及GWB总分、对健康担心、生活满足、愉快心境维度评分差异有统计学意义(P均<0.01)。重复测量方差分析显示,两组在不同时间点的SCL-90、GWB总分及各维度得分差异有统计学意义(P均<0.01);SCL-90总分及躯体化、焦虑、抑郁因子分的组间效应和交互效应显著(P均<0.01);两组GWB总分及对健康担心、生活满足、愉快心境维度评分的组间效应和交互效应显著(P均<0.01)。干预前后两组SCSQ和GSES评分差值协方差分析显示组别主效应显著(P均<0.01)。结论:综合干预模式可减轻门诊GAD患者的临床症状,改善应对方式,提升总体幸福感和自我效能感。

Objective:To explore the effect of comprehensive intervention on outpatients with generalized anxiety disorder(GAD).Method:A total of 92 outpatients with GAD were assigned into intervention group(n=45)and control group(n=47)according to random number table.All patients received routine outpatient treatment with drugs,the intervention group also received comprehensive intervention(including group cognitive-behavioral therapy and disease management out of hospiatal),the course was 12 weeks.Symptom Checklist 90(SCL-90),General Well-Being Schedule(GWB),Simplified Coping Style Questionnaire(SCSQ),General Self-Efficacy Scale(GSES)were used at four time points:before intervention,a month after intervention,intervention finished and a month after intervention finished.Results:There were statistically significant differences between the two groups on the total scores of SCL-90 and subscale scores of somatization,depression,anxiety and the score of worrying about health of GWB a month after intervention(P<0.05 or P<0.01).There were also statistically significant differences in total score of SCL-90 and subscale scores of somatization,depression,anxiety,and total score of GWB and subscale scores of worrying about health,life satisfaction and happy feeling at the time points of intervention finished,a month after intervention finished(P<0.01).The results of repeated measure variance analysis showed that there were significant differences in the total score and scores of each dimension in SCL-90 and GWB between the two groups(P<0.01).The total score of SCL-90 and subscale scores of somatization,depression,anxiety had significant group effect and interaction effect(P<0.01).The total score of GWB and subscale scores of worrying about health,life satisfaction and happy feeling also had significant group effect and interaction effect(P<0.01).The main effect of group was statistically significant on the scores of SCSQ and GSES before and after intervention(P<0.01).Conclusion:Comprehensive intervention can decrease symptoms in outpatients with GAD,improve the coping style,sense of general well-being and self-efficacy.