正念疗法对有抑郁情绪的海洛因成瘾者的疗效

The effects of mindfulness therapy on heroin addicts with depressive mood

目的探索正念疗法对有抑郁情绪的海洛因成瘾者心理干预的疗效。方法纳入有抑郁情绪的海洛因成瘾者150例,采用随机数字表法将患者随机分为对照组(n=75)和试验组(n=75)。对照组给予常规心理支持治疗,试验组在常规心理支持治疗的基础上,再给予正念疗法进行心理干预,采用焦虑自评量表(Self-rating Anxiety Scale,SAS)、抑郁自评量表(Self-rating Depression Scale,SDS)、一般自我效能感量表(General Self-Efficacy Scale,GSES)、视觉模拟评分法(Visual Analogue Scale,VAS)评价疼痛、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、戒毒动机评分量表(Abstaining Motivation Questionnaire,AMQ)对两组患者干预前后抑郁、焦虑、自我效能感、戒毒动机、疼痛症状、睡眠质量的评分差值进行比较。于治疗结束后1、6个月通过在门诊随访结合尿检的方式调查复吸情况。采用t检验对两组在干预前后的指标评价得分差值进行比较,采用χ2检验对两组复吸率进行比较。结果试验组在干预后SAS评分、SDS评分、GSES评分、VAS评分、PSQI评分、AMQ总评分及趋戒—内部动机、趋戒—外部动机、避吸—内部动机、避吸—外部动机、戒毒信心五个维度的评分及干预前后评分的差值均明显高于对照组(P<0.001)。试验组干预后1个月复吸率为5.33%,6个月复吸率为18.67%,均明显低于对照组(P<0.05)。结论正念疗法可减轻海洛因成瘾者戒毒期间抑郁、焦虑、疼痛症状,提高睡眠质量,提升戒毒信心及戒毒动机,降低复吸率。

Objective To explore the effects of mindfulness therapy on psychological intervention of heroin addicts with depressive mood.Methods A total of 150 heroin addicts with depression were enrolled and randomly divided into control group(n=75)and experimental group(n=75).The control group was given conventional psychological support treatment,while the experimental group was given psychological intervention with mindfulness therapy on the basis of conventional psychological support treatment.Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),General Self-fficacy Scale(CSES),Visual Analogue Scale(VAS),Pittsburgh Sleep Quality Index(PSQI)and Abstaining Motivation Questionnaire(AMQ)were used to evaluated depression,anxiety,self-efficacy,drug withdrawal motivation,pain symptoms and sleep quality of the two groups.Differences of these characteristics between two groups were compared before and after the intervention.Relapse was investigated at 1 and 6 months after the end of treatment through outpatient follow-up and urine test.Results Before and after the intervention,the difference of SAS score,SDS score,GSES score,VAS score,PSQI index score,AMQ total score and five dimensions of abstinence internal motivation,abstinence external motivation,abstinence internal motivation,abstinence external motivation and abstinence confidence in the experimental group were significantly higher than those in control group(P<0.001).The relapse rate in the experimental group was 5.33% at 1 month and 18.67% at 6-months after intervention respectively,which were significantly lower than those in control group(P<0.05).Conclusion Mindfulness therapy can reduce the symptoms of depression,anxiety,improve the quality of sleep,enhance the confidence and motivation of detoxification,and reduce the relapse rate of heroin addicts.