认知行为治疗联合积极心理干预对酒精使用障碍伴抑郁患者的效果

Effect of cognitive behavioral therapy combined with positive psychological intervention on comorbid alcohol use disorder and depression

目的探究认知行为治疗(CBT)联合积极心理干预对酒精使用障碍(AUD)伴抑郁患者酒精戒断反应、负性情绪以及复饮情况的影响。方法将184例AUD伴抑郁患者按照随机数字表法分为对照组和研究组,各92例。对照组患者给予常规药物治疗,研究组患者在对照组基础上给予CBT联合积极心理干预。比较治疗前后两组患者修订版临床酒精戒断症状评定量表(CIWAAr)、宾夕法尼亚酒精渴求量表(PACS)、汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、药物成瘾者生存质量测定量表(QOL-DA)评分,并随访半年统计两组患者的复饮情况。结果对照组脱落2例,研究组脱落0例,最终对照组纳入90例,研究组纳入92例。治疗后,两组患者CIWA-Ar、PACS、HAMA、HAMD评分均低于治疗前,且研究组低于对照组(P<0.01)。治疗后,两组患者QOL-DA各维度评分均高于治疗前,且研究组高于对照组(P<0.01)。随访8周、16周、24周,研究组患者复饮率均低于对照组(P<0.05)。结论对AUD伴抑郁患者在常规药物治疗的基础上给予CBT联合积极心理干预,可有效帮助患者戒断酒精依赖,减轻其负性情绪,降低复饮率,改善生存质量。

Objective To explore the effect of cognitive behavioral therapy(CBT)combined with positive psychological intervention(PPI)on alcohol withdrawal reactions,negative emotions and resumption of drinking in patients with comorbid alcohol use disorder(AUD)and depression.Methods A total of 184patients with comorbid AUD and depression were divided into control and research group according to ra ndom number table,with 92 ones in each.Cont rols received conventional d r ug t reatment,on the basis of controls research group did CBT+PPI.Pre-and post-treatment such scales scores were compa red between two groups as the revised Clinical Institute Withd rawal Assessment for Alcohol Scale(CIWA-Ar),Penn Alcohol Craving Scale(PACS),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(H A M D)a nd Quality of Life Scale for Dr ug Addicts(QOL-DA),the resumption of drinking within half a year of follow-up was counted.Results Two patients dropped out in control group and zero in research group,finally,ninety ones were enrolled in control group and 92 in research group.After treatment scores on the CIWA-Ar,PACS,HAMA and HAMD of both groups were lower compared with pre-trea tment,sowe rethose in resea rch t ha n cont rol g roup(P<0.01).Af ter treatment all dimensions scores of the QOL-DA in both g roups were higher compa red with pretreatment,so were those in research than control group(P<0.01).Red rinking rates in week 8,16 and 24 of follow-up were lower in research than control group(P<0.05).Conclusion CBT+PPI based on conventional drug treatment can effectively help patients quit alcohol dependence of patients with comorbid AUD and depression,alleviate negative emotions,lower redrinking rate,and improve the quality of life.