相对卧床式森田疗法对复发性抑郁障碍患者人格特征和疗效的影响

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目的:探讨相对卧床式森田疗法对复发性抑郁障碍患者人格特征和疗效的影响。方法:选取2019年6月至2019年10月在开滦精神卫生中心住院治疗复发性抑郁障碍患者70例,分为研究组(35例)和对照组(35例)。对照组给予常规治疗;研究组在常规治疗的基础上给予相对卧床式森田疗法。采用艾森克人格问卷(Eysenck personality questionnaire,EPQ)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)和汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评定患者人格特征与临床症状,并进行分析比较。结果:(1)艾森克人格问卷各维度评分:组内不同时点间内外向维度评分[研究组:入组时:(46.14±10.99)分;5周末:(50.43±8.86)分;8周末:(53.86±7.08)分;n F=6.291,n P=0.003;对照组:入组时:(45.29±8.99)分;5周末:(48.29±8.31)分;8周末:(50.29±7.57)分;n F=3.211,n P=0.044]、神经质维度评分[研究组:入组时:(60.14±5.49)分;5周末:(53.29±4.53)分;8周末:(50.57±4.33)分;n F=36.809,n P<0.001;对照组:入组时:(60.29±6.18)分;5周末:(55.86±6.00)分;8周末:(53.14±5.30);n F=13.353,n P<0.001]差异有统计学意义。同一时点两组间神经质维度评分(5周末:n F=4.095,n P=0.047,8周末:n F=4.940,n P=0.030)差异均有统计学意义;入组8周后两组间内外向E维度评分差异有统计学意义(n F=4.157,n P=0.045)。精神质维度评分在组内不同时点和组间同一时点差异均无统计学意义。(2)汉密尔顿抑郁量表评分:组内不同时点间评分差异有统计学意义[研究组:入组时:(32.00±4.04)分;5周末:(15.23±5.01)分;8周末:(9.31±3.15)分;n F=282.376,n P<0.001;对照组:入组时:(31.91±4.59)分;5周末:(17.86±5.11)分;8周末:(11.17±3.64);n F=195.019,n P<0.001],同一时点两组间评分差异比较均有统计学意义(5周末:n F=4.724,n P=0.033;8周末:n F=5.205,n P=0.026)。(3)汉密尔顿焦虑量表评分:组内不同时点间评分差异有统计学意义[研究组:入组时:(18.69±8.87)分;5周末:(10.34±5.34)分;8周末:(7.97±2.98);n F=28.679,n P<0.001;对照组:入组时:(18.60±8.02)分;5周末:(13.31±6.35)分;8周末:(10.37±4.86)分;n F=14.241,n P<0.001],同一时点两组间评分差异均有统计学意义(5周末:n F=4.161,n P=0.045;8周末:n F=8.315,n P=005)。(4)多元线性回归结果提示,森田疗法(n β=-0.312,n t=-2.360,n P=0.022)、内外向人格特质(n β=-0.334,n t=-2.355,n P=0.022)是HAMA的影响因素。n 结论:相比接受单纯常规治疗,给予相对卧床式森田疗法,可通过增强患者外向性人格特征进而减轻焦虑症状,同时亦能改善其抑郁症状。“,”Objective:To investigate the effect of Relative Bedrest Condition Morita Therapy(RBCMT) on the improvement of depression and anxiety symptoms and personality in patients with recurrent depression disorder.Methods:Seventy patients with recurrent depressive disorder hospitalized in Kailuan Mental Health Center were randomly divided into study group and control group(n n=35 in each group) from June to October, 2019.The study group was given RBCMT on the basis of conventional treatment and nursing.The Eysenck personality questionnaire (EPQ), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to assess the clinical symptoms and personality characteristics of the patients and to analyze and compare them.n Results:(1) EPQ score in each dimension: There were significant differences within group among different time in introverted and extroverted dimension (study group: baseline: 46.14±10.99, the fifth weekend: 50.43±8.86, the eighth weekend: 53.86±7.08, n F=6.291, n P=0.003.Control group: baseline: 45.29±8.99, the fifth weekend: 48.29±8.31, the eighth weekend: 50.29±7.57, n F=3.211, n P=0.044) and neuroticism dimension score (study group: baseline: 60.14±5.49, the fifth weekend: 53.29±4.53, the eighth weekend: 50.57±4.33, n F=36.809, n P<0.001.Control group: baseline: 60.29±6.18, the fifth weekend: 55.86±6.00, the eighth weekend: 53.14±5.30,n F=13.353, n P<0.001) among different time points in the group.Neuroticism scores between the two groups at the same time were statistically significant(the fifth weekend:n F=4.095, n P=0.047, the eighth weekend: n F=4.940, n P=0.030). After 8 weeks of inclusion, there was a statistically significant difference between the two groups in the score of introverted and extroverted dimension (n F=4.157, n P=0.045). There was no significant difference in the score of spiritual quality dimension at different time within the group or at the same time point between the groups.(2)HAMD score: There were statistically significant differences within group among different time(study group: baseline: 32.00±4.04, the fifth weekend: 15.23±5.01, the eighth weekend: 9.31±3.15, n F=282.376, n P<0.001.Control group: baseline: 31.91±4.59, the fifth weekend: 17.86±5.11, the eighth weekend: 11.17±3.64,n F=195.019, n P<0.001), and the differences between the two groups at the same time were statistically significant (the fifth weekend:n F=4.724, n P=0.033, the eighth weekend: n F=5.205, n P=0.026). (3)HAMA score: There were statistically significant differences within group among different time(study group: baseline: 18.69±8.87, the fifth weekend: 10.34±5.34, the eighth weekend: 7.97±2.98, n F=28.679, n P<0.001.Control group: baseline: 18.60±8.02, the fifth weekend: 13.31±6.35, the eighth weekend: 10.37±4.86,n F=14.241, n P<0.001). The difference between the two groups at the same time point was statistically significant (the fifth weekend:n F=4.161, n P=0.045, the eighth weekend: n F=8.315, n P=005). (4)Multiple linear regression results indicated that RBCMT (n β=-0.312, n t=-2.360, n P=0.022) and introverted and extroverted dimension personality (n β=-0.334, n t=-2.355, n P=0.022) were the influencing factors of HAMA.n Conclusion:Compared with the conventional treatment, the Relative Bedrest Condition Morita Therapy can reduce the anxiety symptoms and improve the depressive symptoms by enhancing the extraversion personality characteristics of the patients.
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