音乐放松疗法改善抑郁障碍患者症状的影响因素及预测模型的构建

Influencing factors of music relaxation therapy to improve symptoms of depressive disorder and the construction of the corresponding prediction model

目的分析音乐放松疗法改善抑郁障碍患者症状的影响因素,并构建相应的预测模型。方法选取2018年1月至2020年1月在山东省精神卫生中心就诊的抑郁障碍患者226例,对患者实施音乐放松疗法治疗。根据音乐放松疗法治疗后BPRS评分的减分率分为有效组(减分率≥25%)和无效组(减分率<25%),分析影响两组患者症状改善的因素。采用阳性和阴性症状量表(PANSS评分)评估患者疾病严重程度,将PANSS评分<4分者为轻度、PANSS评分5~6分为中度、PANSS评分>6分者为重度,运用Logistic多因素回归方法分析音乐放松疗法对抑郁障碍患者症状改善的影响因素,建立影响因素预测模型,对模型的真实性和可靠性进行验证,并绘制音乐放松疗法改善抑郁障碍患者症状的预测列线图。结果两组患者性别、文化程度、精神疾病家族史和治疗前病情严重程度等方面差异有统计学意义(P<0.05);Logistic多因素分析结果显示,性别、精神疾病家族史、治疗前病情严重程度以及HAMD评分、HAMA评分是影响音乐放松疗法对抑郁障碍患者治疗效果的相关因素(P<0.05)。以女性、无精神疾病家族史、治疗前病情为轻度以及HAMD评分(<7分)、HAMA评分(<8分)构建音乐放松疗法对抑郁障碍患者症状改善的影响因素预测模型,AUC(95%CI)为0.631(0.555~0.762),预测模型准确性较高,症状改善的预测发生率与实际发生率一致性较高。结论女性、无精神疾病家族史、治疗前抑郁障碍症状轻度的患者对音乐放松疗法的治疗反应较好。研究构建的预测模型可为抑郁障碍患者治疗方案的选择提供参考依据。

Objective To analyze the influencing factors of music relaxation therapy to improve symptoms of depressive disorder and the construction of the corresponding prediction model.Methods A total of 226 patients with depression who visited Shandong Mental Health Center from January 2018 to January 2020 were selected and treated with music relaxation therapy.According to the reduction rate of BPRS score after music relaxation therapy,patients were divided into effective group(reduction rate greater than or equal to 25%)and ineffective group(reduction rate less than 25%),and the factors influencing symptom improvement of patients in the two groups were analyzed.Positive and negative Symptom Scale(PANSS score)was used to evaluate the disease severity of patients.Patients with PANSS score less than 4 were classified as mild,PANSS score of 5 to 6 was classified as moderate,and PANSS score greater than 6 was classified as severe.Logistic multifactor regression method was used to analyze the influencing factors of music relaxation therapy on the improvement of symptoms in patients with depressive disorder,establish the prediction model of influencing factors,verify the authenticity and reliability of the model,and draw the prediction column chart of music relaxation therapy on the improvement of symptoms in patients with depressive disorder.Results There were statistically significant differences between the two groups in gender,education level,family history of mental illness and severity of illness before treatment(P<0.05).Logistic multifactor analysis showed that gender,family history of mental illness,severity of illness before treatment,HAMD score and HAMA score were the related factors affecting the therapeutic effect of music relaxation therapy on patients with depressive disorder(P<0.05).The predictive model of the influence factors of music relaxation therapy on the improvement of symptoms of patients with mental disorders was constructed with female,no family history of mental illness,mild condition before treatment,HAMD score(less than7 points)and HAMA score(less than 8 points).The AUC(95%CI)was 0.631(0.555~0.762),indicating a high accuracy of the predictive model.The predicted incidence of symptom improvement was consistent with the actual incidence.Conclusions Female,no family history of mental illness,and mild symptoms of mental disorder before treatment respond better to music relaxation therapy.The predictive model constructed by the research can provide a reference for the selection of treatment options for patients with mental disorders.