心理动力性治疗联合低频重复经颅磁刺激对青少年抑郁症自杀意念的影响研究

Effect of psychodynamic therapy combined with low-frequency repetitive transcranial magnetic stimulation on suicidal ideation in adolescents with depression

目的探讨心理动力性治疗联合低频重复经颅磁刺激(rTMS)对青少年抑郁症自杀意念的影响。方法选取90例青少年抑郁症患者,按照随机数字表法分为观察组和对照组,各45例。对照组行低频rTMS,观察组在对照组基础上联合心理动力性治疗,比较两组患者干预前后的睡眠障碍、抑郁情况、神经功能及自杀意念。结果观察组患者干预后夜醒次数、睡眠抵触、睡眠潜伏期及总睡眠时间评分均低于对照组,差异均有统计学意义(t分别=43.72、5.70、18.68、19.44,P均<0.05);观察组干预后焦虑躯体化、认知障碍、日夜变化、迟缓、睡眠障碍、绝望感评分及总分均低于对照组,差异均有统计学意义(t分别=6.11、12.55、18.54、3.79、16.58、4.47、3.83,P均<0.05);观察组干预后总应答数、正确应答数、完成分类数均高于对照组,错误应答数、持续性错误数均低于对照组,差异均有统计学意义(t分别=-5.38、-10.02、-8.07、4.66、6.01,P均<0.05);观察组干预后Beck自杀意念、Beck自杀倾向、Beck总评分均低于对照组,差异均有统计学意义(t分别=8.89、3.82、5.55,P均<0.05)。结论心理动力性治疗联合低频rTMS可有效降低青少年抑郁症的自杀意念。

Objective To explore the effect of psychodynamic therapy combined with low-frequency repetitive transcra⁃nial magnetic stimulation(rTMS)on suicidal ideation in adolescents with depression.Method A total of 90 adolescent pa⁃tients with depression were selected and randomly divided into observation group and control group,with 45 cases in each.The control group received low-frequency rTMS,while the observation group received psychodynamic therapy in addition to the control group.The sleep disorders,depression,neurological function,and suicidal ideation of the two groups of pa⁃tients before and after intervention were compared.Results After intervention,the number of night awakenings,sleep re⁃sistance,sleep latency,and total sleep time scores of the observation group were lower than those of the control group,and the differences were statistically significant(t=43.72,5.70,18.68,19.44,P<0.05).After intervention,the anxiety somatiza⁃tion,cognitive impairment,day night changes,delay,sleep disorders,despair scores,and total scores of the observation group were lower than those of the control group,and the differences were statistically significant(t=6.11,12.55,18.54,3.79,16.58,4.47,3.83,P<0.05).After intervention,the total number of response administered,response correct and catego⁃ries completed of the observation group were higher than those of the control group,and the number of response errors and response persistent errors were lower than those of the control group,the differences were statistically significant(t=-5.38,-10.02,-8.07,4.66,6.01,P<0.05).After intervention,the Beck suicide beliefs,Beck suicidal tendencies,and Beck total scores of the observation group were lower than those of the control group,the differences were statistically significant(t=8.89,3.82,5.55,P<0.05).Conclusion Psychodynamic therapy combined with low-frequency rTMS can effectively re⁃duce suicidal ideation in adolescents with depression.