家庭因素在强迫症团体认知行为治疗中的效果探究

Research on the effect of family factors in group cognitive behavioral therapy for obsessive-compulsive disorder

目的 探究在强迫症团体认知行为治疗中家庭因素对治疗效果的影响。方法 82例强迫症患者,以团体认知行为治疗是否联合家属心理健康教育分为治疗1组(41例,因未完成10次团体治疗脱落2例,最终39例)和治疗2组(41例,因未完成10次团体治疗脱落1例,最终40例)。治疗1组采用单纯团体认知行为治疗,治疗2组采用团体认知行为治疗联合家属心理健康教育。对比两组患者的一般资料,治疗前后耶鲁-布朗强迫症状量表(Y-BOCS)评分,不同家庭支持水平患者Y-BOCS评分减分率,分析强迫症患者团体认知行为治疗的影响因素。结果 两组患者的性别、年龄、病程、教育程度对比,差异无统计学意义(P>0.05);治疗2组患者的家庭支持量表(PSS-Fa)评分(9.48±3.11)分高于治疗1组的(7.31±3.29)分,家庭支持水平优于治疗1组,差异具有统计学意义(P<0.05)。两组治疗前Y-BOCS评分对比,差异无统计学意义(P>0.05);治疗后,两组Y-BOCS评分均低于本组治疗前,且治疗2组Y-BOCS评分(13.88±4.58)分低于治疗1组的(17.10±4.70)分,差异具有统计学意义(P<0.05)。治疗2组、治疗1组不同家庭支持水平患者Y-BOCS评分减分率对比,差异具有统计学意义(F=18.155、40.713,P=0.000、0.000<0.05)。两组低、高家庭支持水平患者Y-BOCS评分减分率对比,差异具有统计学意义(P<0.05);两组中家庭支持水平患者Y-BOCS评分减分率对比,差异无统计学意义(P>0.05)。Logistic回归分析结果显示,伴有家属心理健康教育[OR=9.886,95%CI=(1.424,68.646),P=0.020],PSS-Fa评分[OR=2.656,95%CI=(1.637,4.308),P=0.000]是强迫症患者团体认知行为治疗的影响因素。结论 强迫症团体认知行为治疗能有效帮助强迫症患者,家属参与强迫症患者的治疗能有效的帮助症状改善。

Objective To investigate the effect of family factors in group cognitive behavioral therapy for obsessive-compulsive disorder.Methods A total of 82 patients with obsessive-compulsive disorder were divided into treatment group 1(41 cases,2 cases dropped off due to failure to complete 10 times of group therapy,39 cases finally) and treatment group 2(41 cases,1 case dropped off due to failure to complete 10 times of group therapy,40 cases finally) according to whether group cognitive behavioral therapy was combined with family members’ mental health education.Treatment group 1 used group cognitive-behavioral therapy alone,and treatment group 2 used group cognitive-behavioral therapy combined with family members’ mental health education.The general data,Y-BOCS score before and after treatment,and the rate of Yale-Brown obsessive compulsive symptom scale(Y-BOCS) score reduction in patients with different levels of family support were compared between the two groups,and the influencing factors of group cognitive behavioral therapy for obsessive-compulsive disorder patients were analyzed.Results There was no statistically significant difference between the two groups in terms of gender,age,disease duration,and education(P>0.05).The perceived social support from family scale(PSS-Fa) scores(9.48±3.11) points in the treatment group 2 were higher than(7.31±3.29) points in the treatment group 1,and the level of family support was better than that in the treatment group 1,and the differences were statistically significant(P0.05).After treatment,the Y-BOCS scores in both groups were lower than those before treatment in this group,and the Y-BOCS score(13.88±4.58) points in treatment group 2 was lower than(17.10±4.70) points in treatment group 1,and the differences were statistically significant(P0.05) in the rate of Y-BOCS scores reduction between the two groups of patients with medium levels of family support.Logistic regression analysis showed that concomitant family mental health education [OR=9.886,95%CI=(1.424,68.646),P=0.020] and PSSFa score [OR=2.656,95%CI=(1.637,4.308),P=0.000] were the factors influencing group cognitive-behavioral treatment for patients with obsessive-compulsive disorder.Conclusion Group cognitive behavior therapy can effectively help patients with obsessive-compulsive disorder,and family members’ s participation can effectively help improve symptoms of patients with obsessive-compulsive disorder.