认知行为疗法在老年抑郁症患者中的应用效果

摘要

目的 探讨认知行为疗法(CBT)对老年抑郁症患者临床症状及自杀意念的疗效.方法 本研究采用病例对照的研究方法,对2014年4月至2016年4月在我院住院治疗的85例老年抑郁症有自杀意念的患者进行研究,按照随机数字表法随机分为两组,观察组45例,对照组40例,两组均给予常规药物治疗,观察组在常规药物治疗的基础上联合CBT,每周2次,每次1 h,治疗8周.分别于治疗前、治疗4周、治疗8周后采用汉密尔顿抑郁量表(HAMD)和自杀意念自评量表(SIOSS)对治疗效果进行评分并比较.结果 (1)两组患者在年龄、性别、民族、职业、有无配偶、受教育程度等方面比较差异均无统计学意义(P>0.05);(2)两组患者治疗前HAMD评分比较差异无统计学意义(P>0.05),治疗4周、8周后两组患者的评分均有不同程度的降低,但观察组降低更明显,差异均有统计学意义(P<0.05);(3)两组患者治疗前SIOSS评分比较差异无统计学意义(P>0.05),治疗4周后两组患者的评分均有不同程度的降低,但观察组降低更明显,主要体现在绝望因子及睡眠因子方面,差异均有统计学意义(P<0.05);随着治疗时间的延长,8周后差异更明显,主要体现在绝望因子、睡眠因子及乐观因子,差异均有统计学意义(P<0.05).结论 CBT治疗可以改善老年抑郁症患者的临床症状,提高患者睡眠质量,降低绝望感,增加乐观积极性,从而减轻老年抑郁症患者的自杀意念,降低自杀风险.%Objective To explore the efficacy of cognitive behavior therapy (CBT) on the clinical symptom and suicidal ideation in the treatment of senile depression. Methods From Apr. 2014 to Apr. 2016, 85 patients with se-nile depression with suicidal ideation were randomized to study group (n=45) and control group (n=40), which were treated with CBT combined with drugs and drugs only, respectively, one hour per time, for eight weeks. The 24-item Hamilton Depression Scales (HAMD) and Self-rating Idea of Suicide Scale (SIOSS) were used to assess the severity of depression and risk of suicide at baseline, 4 and 8 weeks after treatment. Results (1) No statistical significance was found at baseline socio-demographic and illness characteristics, including age, gender, nationality, occupation, marriage status, and degree of education (P>0.05). (2) There was no significant difference in HAMD scores between the two groups at baseline (P>0.05). HAMD scores in the two groups were decreased 4 weeks and 8 weeks after treatment, and the reduction in the study group was more significant (P<0.05). (3) There was no significant difference in SIOSS scores between the two groups at baseline (P>0.05). SIOSS scores in the two groups were decreased 4 weeks after treatment, and the reduction in the study group was more significant, mainly reflecting in despair factor and sleep factor (P<0.05). With the extension of treatment time, the difference was more significant 8 weeks after treatment (P<0.01), mainly re-flecting in the sleep factor, desperate factor and optimistic factor (P<0.05). Conclusion CBT treatment can improve the clinical symptoms of senile depressions, improve sleep quality, reduce the sense of despair, increase optimism and enthu-siasm, and thereby reduce the suicidal ideation of senile depressions.