Effect of cognitive behavioral group therapy on rehabilitation of community patients with schizophrenia:A short-term randomized control trial

BACKGROUND The efficacy of cognitive behavioral group therapy(CBGT)for cognitive dysfunction and negative symptoms of schizophrenia is established,but more evidence is required.AIM To assess the effectiveness of CBGT combined with mental health education as a treatment for schizophrenia compared with mental health education alone.METHODS In all,120 schizophrenia out-patients were randomized into CBGT combined with mental health education or single mental health education.The primary outcomes were positive and negative symptoms,cognitive function,excitatory factor,anxiety and depression symptom improvements on the positive and negative syndrome scale score.Secondary outcome measures included social function and drug compliance.RESULTS There were significant differences between CBGT combined with mental health education and single mental health education on measures of positive and negative symptoms,cognitive functions,excitatory factor,anxiety and depression symptoms,and social functions.No other significant difference in outcomes was observed.CONCLUSION CBGT combined with mental health education may be relevant beneficial treatment method in reducing symptoms,cognitive and social functions of patients with schizophrenia.

Impact of group music therapy on the depression mood of college students

The goal of this study was to examine the effects of group music therapy on depression and mental health among college students. 80 students participated in this study, with 40 assigned to control group and other 40 assigned to experimental group. The results showed that after the group music therapy, for the experimental group, the depression scores have reduced significantly and the mental health scores have improved, while for the control group, no significant difference was obtained on the de-pression and mental health scores. This indicates that group music therapy can effectively reduce depression and improve mental health.

Nurse-led group cognitive behavioral therapy for major depressive disorder among adults in Japan: A preliminary single-group study

Objectives:The prevalence and burden of disease of depression necessitates effective and accessible treatment options worldwide.Since April 2016,Japanese national health insurance has covered nurseadministered cognitive behavioral therapy(CBT)for mood disorders.However,empirical support for nurse-led CBT for depression in Asian countries,especially in Japan,is still lacking.This preliminary study aimed to examine the feasibility and acceptability of nurse-led group CBT for Japanese patients with depression.Methods:In this single-arm study,we evaluated the effects of a 6-week group CBT,led by trained nurses,on patients with major depression.The primary outcome was the Beck Depression Inventory-Ⅱ(BDI-Ⅱ).Assessments were conducted at the beginning and end of the intervention.Results:Of 25 participants screened,23 were eligible for the study(of these,three dropped out during the trial but were included in the analysis).Nurse-led group CBT led to significant improvements in the severity of depression(BDI-Ⅱ,P<0.001).The mean total BDI-Ⅱscore improved from 23.1(SD=7.56)to 12.4(SD=8.57),and the pre-to post-effect size was large(Cohen's d=1.33).After CBT,45%of the participants were judged to be treatment responders,and 34%met the remission criteria.Conclusions:Our preliminary findings indicate that 6 weeks of nurse-led group CBT produced a favorable treatment outcome for individuals with major depression in a Japanese clinical setting.The results of this study might encourage more Asian nurses to provide CBT as a part of their nursing practice.Further controlled trials that address the limitations of this study are required.

Cognitive behavioral therapy group intervention for HIV transmission risk behavior in perinatally infected adolescents

Purpose: This study analyzed treatment effects of cognitive behavioral therapy (CBT) group counseling intervention on HIV transmission risk behavior, depression, anxiety, and alcohol use in HIV perinatally infected adolescents attending an HIV clinical care center in Uganda, Africa. Method: A total of 186 adolescents were randomly assigned to an experimental or control arm and assigned into groups of 11 - 16 adolescents. The experimental groups received an 80-minute CBT based weekly intervention for 8 consecutive weeks, while the control groups received only standard group care. Data from self report assessments were analyzed at pre- and post-test using repeated measures of analysis of variance. The participants, analyzed by variable, included 115 for sexual behavior, 106 for depression, 88 for anxiety, and 115 for alcohol use. Results: The results from the study show a large significant difference (p = 0.006) between the experimental and control groups on the anxiety variable. There were no significant differences between the experimental and control groups on the variables of sexual behavior (p = 0.876), depression (p = 0.700), and alcohol use (p = 0.815). There was an indication of reduced levels of HIV sexual transmission risk behavior, depression, and alcohol use levels in the participants in both the experimental and control groups. Conclusions: Risky sexual behavior places HIV perinatally infected adolescents at risk of re-infection, sexually transmitted diseases, and transmitting HIV to their sexual partners. CBT group counseling intervention equipped the participating adolescents with appropriate life skills to deal with psychological distress and anxiety often seen in their lives and may be useful in routine medical care to reduce transmission risks and improve wellness and call for its incorporation into HIV preventive programs and counselor education.

Group Therapy in Adults with Obsessive-Compulsive Disorder: A Review

In the treatment of OCD, several therapeutic approaches have been developed, including individual, group and/or pharmacological therapeutic methods. However, group therapy on OCD has received little research attention in comparison with other therapeutic methods and some studies demonstrated that OCD can be treated in group settings. In the literature, mentioned group therapies to treat OCD involve behavioral therapy, cognitive therapy, ERP (exposure and response prevention), cognitive behavioral therapy, ACT (acceptance and commitment therapy), supportive groups and individual therapy with family member involvement. In relation to their effectiveness, research indicated inconsistent findings. Therefore, the aim of this study was to address and to review whether group treatments on OCD are efficacious. This review focused on cognitive-behavioral group therapy (CBGT), ERP, and ACT.

Effectiveness of Group Therapy Based on Transactional Analysis (TA) in Marital Burnout and Forbearance of Female Students

This research is a semi-experimental study (pretest-posttest design with unequal control group). This study aimed to investigate the effectiveness of the group therapy based on transactional analysis in marital burnout and forbearance of married female students. The research on statistical population comprised all married female students studying in humanities subjects in Neishabour Islamic Azad University in the academic year 2015-16. The sample included 24 of these students, who were selected voluntarily and through Random sampling method and were randomly assigned into two experimental and control groups. Measurement tools consisted of Couple Burnout Measure (CBM) and Evans marital forbearance questionnaire. The experimental group received 10 one-half hour sessions of the treatment based on the transactional analysis whereas in the meantime, the control group received nutritional trainings. The results indicated that the therapy based on the transactional analysis had been effective in reducing marital burnout and increasing the forbearance of couples.

EFFICACY OF ACUPUNCTURE THERAPY ON A, B AND O BLOOD GROUPS ──Relationship between A, B, O blood groups and the acupuncture therapy

Efficacy of acupuncture therapy varies in patients with similar ailments. The present study was undertaken to search for a marker for better efficacy of acupuncture therapy. The study was made in 224 patients including osteoarthritis 141 (62.94 %), polyarthritis 23 (10.26 %), Bursitis & synovitis 15 (6.69 %) and others 45 (20.08 %). ABO blood groups were tested for each patient. It appears that patients belonging to group AB and B responded well to acupuncture therapy in proportionately more number. Good result was achieved in 47.82 % cases in group AB and 46.04 % cases in group B, whereas patients of group A and O showed good result in 27.65 % and 26.15 % cases respectively. Apparently it may be concluded that patients of AB & B blood groups would respond comparatively well to acupuncture therapy.

短程焦点解决团体疗法对脑瘫患儿父母创伤后成长体验病耻感及照顾能力的影响

目的探讨短程焦点解决团体疗法对脑瘫患儿父母创伤后成长体验、病耻感及照顾能力的影响。方法将脑瘫患儿的81名父母按照随机数字表法分为研究组(40名)和对照组(41名)。对照组患儿父母给予常规心理护理,研究组患儿父母在对照组基础上给予短程焦点解决团体疗法,观察3周。比较干预前后两组患儿父母焦虑自评量表(SAS)、抑郁自评量表(SDS)、创伤后成长量表(PTGI)、连带病耻感量表(ASS)、家属照顾者照顾能力量表(FCTI)评分及护理满意度。结果干预后两组患儿父母SAS评分、SDS评分、ASS各维度评分、FCTI各维度评分均较干预前降低,研究组患儿父母低于对照组(P<0.01)。干预后两组患儿父母PTGI各维度评分均较干预前升高,研究组患儿父母高于对照组(P<0.01)。研究组患儿父母护理总满意度高于对照组(P<0.05)。结论短程焦点解决团体疗法能缓解脑瘫患儿的父母焦虑、抑郁情绪,减轻其病耻感,促进其创伤后成长,提升其照顾能力,有利于提高护理满意度。

CHS-DRG付费制度下药物治疗路径化管理在骨科围手术期合理预防性使用重组人促红细胞生成素的应用效果研究

目的:探讨基于国家医疗保障疾病诊断相关分组(CHS-DRG)付费方式改革下,围手术期重组人促红细胞生成素(rhEPO)路径化管理在骨科的应用效果。方法:采用德尔菲法,经过2轮计划-执行-检查-行动(PDCA)循环优化,制定了rhEPO药物治疗路径。以2022年3—7月该院骨科住院患者为管理前组,2023年3—7月的患者为管理后组。选取rhEPO使用率最高的8个DRG病种,比较管理前后的效益指标(次均住院费用、次均药品费用、平均住院时间、rhEPO使用合理率、输血率)改善程度。结果:与路径化管理前比较,路径化管理后骨科住院患者的次均住院费用由58 829.79元降至48 259.29元(P<0.05),次均药品费用由3 311.23元降至2 987.52元(P<0.05),平均住院时间由10.1 d缩短至8.05 d(P<0.01),差异均有统计学意义;rhEPO使用合理率由26.27%(62/236)提高至91.54%(238/260),输血率由34.66%(165/476)降至25.57%(169/661)。结论:通过路径化管理模式制定药物标准化方案,可优化资源配置,提高医疗质量,有效改善DRG病种效益指标。

短程团体认知行为治疗联合计算机化认知行为治疗对青少年抑郁的改善作用

目的探讨短程团体认知行为治疗(Group Cognitive Behavioral Therapy,GCBT)对青少年抑郁症患者的疗效,观察短程GCBT和计算机化认知行为治疗(Computerized Cognitive Behavioral Therapy,CCBT)联合对青少年抑郁治疗疗效。方法随机选取2022年8月—2023年8月福建省福州神经精神病防治院精神科门诊及医学心理咨询中心门诊收治的90例青少年抑郁症患者为研究对象,通过随机数表法分为CCBT组(n=30,因未完成5次治疗脱落19例,最终11例)、GCBT组(n=30,因未完成5次团体治疗脱落3例,最终27例)及CCBT+GCBT组(n=30)。在服用抗抑郁药物基础上,CCBT组合并5周的CCBT,GCBT组合并5周的GCBT,CCBT+GCBT组合并5周的GCBT及CCBT。治疗频率均为1次/周。比较3组治疗前、后汉密尔顿抑郁量表(24 Items Hamilton Depression Scale,HAMD-24)评分及减分率,中学生心理健康量表(Mental Health Scale for Middle School Students,MSSMHS)总均分及各因子分。结果5周治疗后,3组HAMD-24评分[CCBT组16(9,18)分、GCBT组18(13,21)分、CCBT+GCBT组13.5(8,20.25)分]均有明显下降,差异有统计学意义(Z=-2.847、-4.545、-4.784,P均<0.05)。3组HAMD减分率比较,差异无统计学意义(P=0.069)。CCBT+GCBT组MSSMHS总均分及强迫、敌对、人际关系敏感、抑郁、焦虑、情绪不平衡及心理不平衡等因子分与治疗前比较,差异有统计学意义(P均<0.05);GCBT组MSSMHS总均分及强迫、敌对、抑郁及情绪不平衡等因子分与治疗前比较,差异有统计学意义(P均<0.05)。CCBT+GCBT组MSSMHS人际关系敏感及心理不平衡因子分较GCBT组明显改善,差异有统计学意义(P均<0.05)。结论短程CCBT及GCBT等治疗能有效改善青少年患者的抑郁症状,且CCBT与GCBT联合治疗疗效更优于单纯GCBT,且能有效降低CCBT高脱失率。

团体接纳与承诺疗法联合有氧运动对血液透析患者的影响

目的:探讨团体接纳与承诺疗法联合有氧运动对血液透析患者的影响。方法:选取2021年2月—2022年2月厦门大学附属第一医院肾内科血透室收治的94例血液透析患者。根据随机数表法将其分为对照组和研究组,各47例。对照组实施常规护理,研究组在对照组基础上给予团体接纳与承诺疗法联合有氧运动。比较两组干预前后疲乏情况、希望水平、应对方式、睡眠质量。结果:干预后,两组积极态度、积极行动、亲密关系评分均升高,研究组积极态度、积极行动、亲密关系评分均高于对照组,差异有统计学意义(P<0.05)。干预后,两组多维度Piper疲乏修订量表(PFS-R)、匹兹堡睡眠质量指数量表(PSQI)评分均降低,研究组PFS-R评分、PSQI评分均低于对照组,差异有统计学意义(P<0.05)。干预后,两组面对应对评分升高,回避、屈服应对评分均降低,研究组面对应对评分高于对照组,回避、屈服应对评分均低于对照组,差异有统计学意义(P<0.05)。结论:团体接纳与承诺疗法联合有氧运动能够有效缓解血液透析患者的疲乏程度,改善患者的心理状态,提高患者的希望水平,使患者积极应对疾病,改善睡眠质量。

照片艺术治疗在高职大学生自我意识完善与发展中的应用研究

目的:以高职大学生为对象,以照片艺术治疗活动为介质,探讨其对促进高职大学生自我意识完善与发展的影响。方法:实验时间分为两个阶段,分别是:2022年3月至6月和2023年3月至6月,通过发布招募信息,学生主动报名,采取随机分组的方式分为实验组(20人)和控制组(20人)。主要观察指标为:自我接纳问卷、自尊量表、自我调控能力问卷、自我认同量表、田纳西自我概念量表。实验组接受8次照片艺术治疗团体心理辅导;控制组不接受任何实验处理。结果:实验组成员经过照片艺术治疗团体心理辅导后其自我意识发生了显著的提升(p<0.05),相较于控制组也呈现出显著性差异(p<0.05)。此外,四周后的追踪结果显示照片艺术治疗团体辅导对学生自我意识的完善与发展方面仍具有持续作用(p<0.05),但这取决于学生通过团体辅导对照片治疗的理念和方法内化于心、外化于行的效果。结论:照片艺术治疗是促进高职大学生自我意识完善与发展的有效途径。

抑郁症网络团体认知行为治疗的单盲随机对照研究

目的:探讨网络团体认知行为治疗(IGCBT)对抑郁症(MDD)患者抑郁情绪、焦虑情绪的疗效。方法:招募MDD患者80例,随机分为IGCBT联合药物治疗组和单纯药物治疗对照组。在基线、治疗4周和8周后分别三次采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)进行盲法评估。结果:联合治疗组4周末HAMD、HAMA以及8周末HAMA的有效率均高于对照组(均P<0.05),联合治疗组、对照组在4周末、8周末时HAMD总分、HAMA总分均低于基线得分(均P<0.001),在基线、4周末、8周末,联合治疗组HAMD总分、HAMA总分均低于对照组得分(均P<0.01)。结论:本研究提示,网络团体认知行为治疗联合抗抑郁药物治疗比单纯使用药物治疗对患者抑郁情绪、焦虑情绪的缓解效果更好,且对焦虑情绪改善效果更佳。

团体绘画治疗在恢复期精神分裂症住院患者中的应用

目的探讨团体绘画治疗对恢复期精神分裂症住院患者阴性和阳性症状、社会功能和认知功能的影响,为患者提供非药物治疗方法。方法将2022年1月至9月45例本院住院恢复期精神分裂症患者设为对照组,并予以常规药物及康复训练;2022年10月至2023年6月45例恢复期精神分裂症住院患者设为观察组,在对照组基础上团体绘画治疗干预。干预时间8w。干预前后分别采用阳性与阴性症状量表(positive and negative syndrome scale,PANSS)、住院精神患者社会功能量表(scale of social function in psychosis inpatients,SSPI)、重复性成套神经心理状态测验(repeatable battery for the assessment of neuropsychological status,RBANS)比较两组患者阳性与阴性症状、社会功能和认知功能。结果两组各45例患者完成研究。观察组患者阳性阴性症状量表评分干预前后差值高于对照组;观察组患者SSPI评分干预前后差值高于对照组;观察组RBANS评分干预前后差值高于对照组,差异具有统计学意义(均P<0.001)。结论团体绘画治疗可改善患者临床症状,提高患者认知功能,促进社会功能恢复。

团体绘画疗法联合氯氮平治疗慢性精神分裂症疗效观察

目的观察团体绘画疗法联合氯氮平治疗慢性精神分裂症的临床疗效。方法选取2019年2月至2023年2月上海市民政第二精神卫生中心收治的100例慢性精神分裂症患者作为研究对象,按随机数表法均分为对照组和观察组各50例。对照组患者采用氯氮平治疗,观察组患者在对照组治疗的基础上联合团体绘画疗法治疗。两组患者均持续治疗6周,于治疗结束后比较两组患者的临床疗效,以及治疗前后的阳性和阴性症状量表(PANSS)、精神分裂症患者生活质量量表(SQLS)和住院精神患者社会功能评定量表(SSPI)评分,同时比较两组患者的不良反应发生情况。结果观察组患者的治疗总有效率为84.00%,明显高于对照组的66.00%,差异有统计学意义(P<0.05);治疗后,观察组患者的阳性因子评分、阴性因子评分、一般精神病理评分和总分明显低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组患者的心理社会、精力与动力、症状及副反应评分和总分明显低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组患者的日常生活功能、动性及交往情况、社会活动技能评分和总分明显高于对照组,差异均有统计学意义(P<0.05);治疗期间,观察组患者的不良反应总发生率为14.00%,略低于对照组的18.00%,但差异无统计学意义(P>0.05)。结论团体绘画疗法联合氯氮平治疗能够改善慢性精神分裂症患者的阳性/阴性症状,提高其生活质量和社会功能,具有疗效好和安全性高等特点,值得临床推广应用。

CHS-DRG精神疾病分组方案及改进研究

目的对CHS-DRG精神疾病分组方案中改良电休克治疗(MECT)进行研究,为北京市医保完善精神疾病分组提供政策建议。方法依据有无改良电休克治疗将5个病组分为MECT组和非MECT组,分析患者住院和费用数据,采用两独立样本t检验、Wilcoxon秩和检验对数据进行统计学检验,以双侧p<0.05为差异具有统计学意义。结果MECT组的住院天数、总费用、药费、检查费、治疗费、其他费用均高于非MECT组,且差别具有统计学意义(p<0.05)。结论建议将改良电休克治疗纳入CHS-DRG相关病例分组方案,提高改良电休克治疗组的权重系数,增加支付标准。建立谈判机制,动态调整CHS-DRG的分组规则,充分发挥CHS-DRG支付方式对规范诊疗行为、合理控制医疗费用、提高医疗质量、效率的引导作用。

催眠治疗在产后抑郁症团体认知行为治疗中的应用效果

目的探讨催眠治疗在产后抑郁症团体认知行为治疗中的应用效果。方法选取2019年10月至2020年3月在西安市精神卫生中心就诊的61例产后抑郁症患者作为研究对象,按照随机数字表法分为观察组(31例)和对照组(30例)。观察组采用催眠治疗联合团体认知行为治疗,对照组采用团体认知行为治疗,比较两组汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分。结果治疗2、4、6周后,两组HAMD、HAMA评分时间、组间、交互作用比较,差异有统计学意义(P<0.05);治疗后两组HAMD、HAMA评分随着治疗周期的增加而逐渐降低,且均低于治疗前,且观察组低于对照组(P<0.05)。结论催眠治疗联合团体认知行为治疗能提高产后抑郁症的临床效果。

八段锦联合核心肌群训练对膝骨关节炎患者功能的改善作用临床观察

目的:观察中医练功(八段锦)联合核心肌群训练对膝骨关节炎患者膝关节功能的改善作用。方法:参照多中心单盲随机对照研究方法,对84例门诊患者采用简单Doll’s临床病例随机化分组方法分成观察组和对照组。两组均予依托考昔片口服,同时观察组42例,采用中医练功(八段锦)联合核心肌群训练治疗;对照组42例,予常规运动疗法。观测两组治疗前后WOMAC评分、TUGT、FSST耗时(s)、MMT值、血清IL-6等相关指标的变化,同时记录治疗期间出现的不良反应,对收集到的数据进行相关统计学分析。结果:观察组症状改善情况优于对照组(P<0.05)。结论:中医练功(八段锦)联合核心肌群训练相较于常规运动疗法,对膝骨关节炎患者膝关节功能改善作用更优。

团体接纳承诺疗法在炎症性肠病患者心理干预中的应用

目的探讨团体接纳承诺疗法对炎症性肠病患者的心理干预效果。方法将93例炎症性肠病患者按住院时间分为对照组46例、干预组47例。两组均行常规治疗与护理,在此基础上干预组制定和实施团体接纳承诺疗法,连续干预8周。评价两组干预前及干预后(干预8周时及干预后1个月)各项指标。结果两组完成全程研究均为43例;干预后干预组疾病接受度、焦虑、自我管理能力及克罗恩病疾病活动度评分显著优于对照组(均P<0.05)。结论针对炎症性肠病患者制定和实施团体接纳承诺疗法,可有效改善患者负性心态,提高自护能力,促进疾病缓解。