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.
Ameliorating Effect of Short-term Group Cognitive Behavioral Therapy Combined with Computerized Cognitive Behavioral Therapy on Adoles-cent Depression
Objective To evaluate the efficacy of short-course group cognitive behavioral therapy(GCBT)in adoles-cents with depression,and to observe the efficacy of the combination of short-course GCBT and computerized cognitive behavioral therapy(CCBT)in adolescents with depression.Methods A total of 90 adolescents with depression in the outpatient department and medical psychological counseling center of Fuzhou Neuropsychiatric Prevention and Control Hospital in Fujian Province from August 2022 to August 2023 were randomly selected and divided into CCBT group(n= 30,19 cases fell off due to incomplete 5 treatments,11 cases ended),GCBT group(n=30,3 cases fell aff due to incom-plete 5 treatment 27 cases ended)and CCBT+GCBT group(n=30)by random number method.On the basis of antide-pressant medication,CCBT combined with 5 weeks of CCBT,GCBT combined with 5 weeks of GCBT,CCBT+GCBT combined with 5 weeks of GCBT and CCBT.The treatment frequency was 1 time/week.The score and reduction rate of 24 Items Hamilton Depression Scale(HAMD-24)and Mental Health Scale for Middle School Students(MSSMHS)total mean score and each factor score were compared between the three groups before and after treatment.Results After 5 weeks of treatment,HAMD-24 scores[16(9,18)points in CCBT group,18(13,21)points in GCBT group,13.5(8,20.25)points in CCBT+GCBT group]were significantly decreased in all 3 groups,and the differences were statistically significant(Z=-2.847,-4.545,-4.784,all P＜0.05).The reduction trend of HAMD score were compared between the 3 groups,and the difference was not statistically significant(P=0.069).There were statistically significant differences in the total MSSMHS scores and the scores of compulsion,hostility,interpersonal sensitivity,depression,anxiety,emo-tional imbalance and psychological imbalance in CCBT+GCBT group compared with those before treatment(all P＜0.05).There were significant differences in the total MSSMHS scores and factors such as compulsion,hostility,depres-sion and emotional imbalance in GCBT group compared with those before treatment(all P＜0.05).The scores of MSSMHS interpersonal sensitivity and psychological imbalance factors in CCBT+GCBT group were significantly im-proved compared with those in GCBT group,and the differences were statistically significant(all P＜0.05).Conclusion Short-range CCBT and GCBT can effectively improve depressive symptoms in adolescent patients,and the combined treatment of CCBT and GCBT is more effective than GCBT alone,and can effectively reduce the high rate of CCBT loss.
Short-term group cognitive behavioral therapyComputerized cognitive behavioral therapyTeenagersDepression
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维普
