【摘要】 目的探讨认知行为疗法治疗难治性抑郁患者的效果及护理方法。方法便利抽样法选择2009年10月至2010年9月在丽水市第二人民医院住院的40例符合中国精神障碍分类与诊断标准(第3版)抑郁症诊断标准的患者。按入院先后顺序将患者分为观察组和对照组,每组20例。两组患者均采用5-羟色胺再摄取抑制剂类抗抑郁药物治疗20周以上,并联合一种抗精神病药或情绪稳定剂,5-羟色胺再摄取抑制类抗抑郁药剂量相对保持固定(20～40mg/d)。对照组患者进行常规护理,观察组患者采用认知行为疗法及护理。连续治疗20周,采用汉密尔顿抑郁量表(Hamilton depressive scale-17items,HAMD17)和抑郁自评量表(self-rating depressive scale,SDS)对两组患者进行调查。结果治疗前后,两组患者的HAMD评分的差异有统计学意义(均P<0.05);治疗第10周末、第20周末,两组患者HAMD评分的差异有统计学意义(均P<0.05)。治疗前后,两组患者的SDS评分的差异有统计学意义(均P<0.05);治疗第10周末、第20周末,两组患者SDS评分的差异有统计学意义(均P<0.05)。经治疗20周后,两组总有效率差异有统计学意义(χ2=4.56,P<0.05)。结论认知行为疗法及护理可提高难治性抑郁患者的疗效。更多还原

【Abstract】 Objective To observe the effects and nursing approach of cognitive behavior therapy for patients with refractory depression.Methods From October 2009 to September 2010,40 depression patients who met the diagnostic criteria of CCMD3 in No.2 People’s Hospital of Lishui were divided into observation group(n=20) and control group(n=20) based on the sequence of entering the groups.The patients in both groups were treated with selective serotomin reuptake Inhibitors(SSRIs) for over 20 weeks combined with one kind of antipsychotics or mood stabilizers and the dose of SSRIs remained relatively fixed(20~40 mg/d).The patients in the control group and observation group received the routine nursing and cognitive behavior therapy & nursing,respectively.The effectiveness was evaluated with Hamilton depressive scale-17 items(HAMD 17) and self-rating depressive scale(SDS) for 20 weeks.Results After the treatment,there was significant difference on HAMD 17 scores(P<0.05).Significant differences were also detected on HAMD 17 scores at the end of 10th week and 20th week(P<0.05).Significant difference on SDS scores was observed after the treatment(P<0.05).Significant differences were also detected on SDS scores at the end of 10th week and 20th week(P<0.05).After 20 weeks of treatment,the difference on complete remission rate was statistically significant(χ2=4.56,P<0.05).Conclusion The cognitive behavior therapy combined with corresponding nursing approach can improve the effects for patients with refractory depression.更多还原