基于自我控制训练的GCBT在青少年抑郁障碍患者中的干预效果

Intervention effect of group cognitive behavioral therapy based on self-control training in adolescents with depressive disorders

目的探讨基于自我控制训练的团体认知行为疗法(group cognitive behavioral therapy,GCBT)在青少年抑郁障碍患者中的干预效果。方法本文为随机对照试验,采用便利抽样法将佛山市第三人民医院2022年1月至5月接收的青少年抑郁障碍患者86例作为研究对象,采用随机数字表法分为对照组与研究组,计算脱落、退出与剔除后,最终对照组38例、研究组40例纳入分析。对照组男16例,女22例,年龄(16.24±2.69)岁,接受每周1次的常规健康教育,持续7周;研究组男14例,女26例,年龄(16.30±2.75)岁,采用基于自我控制训练的GCBT,每周1次,持续7周。采用《中学生自我控制能力问卷》、汉密尔顿抑郁量表24项(HAMD-24)评价两组入组时与入组2个月后的自我控制能力、抑郁程度、记忆功能、执行功能、注意力功能。统计学方法采用t检验与χ^(2)检验。结果入组2个月,研究组的《中学生自我控制能力问卷》中情绪控制维度、行为控制维度、思维控制维度评分及总分均高于对照组[(35.28±3.37)分比(30.50±3.28)分、(45.68±5.36)分比(39.74±5.13)分、(32.70±3.35)分比(28.78±3.07)分、(113.66±10.73)分比(99.02±9.86)分],差异均有统计学意义(t=6.343、4.995、5.407、6.265,均P<0.05)。入组2个月,研究组的HAMD-24评分低于对照组[(21.40±3.14)分比(23.18±3.52)分],差异有统计学意义(t=2.359,P<0.05)。入组2个月,研究组的记忆功能、执行功能、注意力功能评分均高于对照组[(23.93±1.54)分比(21.68±1.75)分、(27.50±2.16)分比(24.87±2.32)分、(79.83±8.16)分比(72.55±9.27)分],差异均有统计学意义(t=6.036、5.185、3.686,均P<0.05)。结论基于自我控制训练的GCBT与常规健康教育比较,能改善青少年抑郁障碍患者的自我控制能力,降低抑郁程度,提升记忆功能、执行功能与注意功能。

Objective To explore the intervention efficacy of group cognitive behavioral therapy(GCBT)based on self-control training in adolescents with depressive disorders.Methods This study was a randomized controlled trial.A total of 86 adolescents with depressive disorders admitted to the Third People's Hospital of Foshan City from January to May 2022 were randomly divided into a control group and a study group by convenience sampling method with 43 cases in each group.After calculation of shedding,withdrawal,and elimination,38 cases in the control group and 40 cases in the study group were included in the analysis.The control group included 16 males and 22 females,aged(16.24±2.69)years;the study group included 14 males and 26 females,aged(16.30±2.75)years.The control group received routine health education once a week for 7 weeks.The study group received GCBT based on self-control training once a week for 7 weeks.The self-control ability and depression degree were evaluated by Self-control Ability Questionnaire for Middle School Students and Hamilton Depression Scale 24-item(HAMD-24)at the time of enrollment and 2 months after enrollment.The memory function(MF),executive function(EF),and attention function(AT)were evaluated at the time of enrollment and 2 months after enrollment.t test andχ^(2) test were used for statistical analysis.Results Two months after enrollment,the scores of emotional control dimension,behavioral control dimension,and thinking control dimension and total score of the Self-control Ability Questionnaire for Middle School Students of the study group were higher than those of the control group[(35.28±3.37)points vs.(30.50±3.28)points,(45.68±5.36)points vs.(39.74±5.13)points,(32.70±3.35)points vs.(28.78±3.07)points,(113.66±10.73)points vs.(99.02±9.86)points],with statistically significant differences(t=6.343,4.995,5.407,and 6.265;all P<0.05).Two months after enrollment,the HAMD-24 score of the study group was lower than that of the control group[(21.40±3.14)points vs.(23.18±3.52)points],with a statistically significant difference(t=2.359,P<0.05).Two months after enrollment,the scores of MF,EF,and AT in the study group were higher than those in the control group[(23.93±1.54)points vs.(21.68±1.75)points,(27.50±2.16)points vs.(24.87±2.32)points,(79.83±8.16)points vs.(72.55±9.27)points],with statistically significant differences(t=6.036,5.185,and 3.686;all P<0.05).Conclusion Compared with conventional health education,the GCBT based on self-control training can improve the self-control ability,reduce the depression degree,and enhance the MF,EF,and AT in adolescents with depressive disorders.