摘要
目的探讨认知行为疗法对伴慢性疼痛的老年抑郁症患者生存质量的影响。方法符合入组标准的患者共60例，随机数字表法分成认知行为治疗组和非认知行为治疗组，各30例。认知行为治疗组采用认知行为疗法合并米氮平治疗，非认知行为治疗组单用米氮平治疗。于治疗前和治疗第4，12周末分别采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、视觉模拟评分（VAS）分别评定抑郁、焦虑和慢性疼痛的严重程度，采用世界卫生组织生存质量量表（WHOQOL-100）评定患者的生存质量。结果伴慢性疼痛的老年抑郁症患者抑郁、焦虑、慢性疼痛与生存质量呈显著负相关（r=-0．506～-0．676，P〈0．01）。治疗第12周末，认知行为治疗组HAMD（36．82±7．93）分、HAMA（8．26±3．13）分、VAS（4．35±0．52）分以及WHO．QOL-100各领域及总体生存质量评分[分别为（65．71±17．29）分，（92．36±13．55）分，（77．91±12．26）分，（78．33±12．81）分，（81．79±12．43）分，（18．95±11．91）分，（19．98±11．56）分]与人组时比较均差异有极显著性（P〈0．01）；与非认知行为治疗组比较，上述各项评分变化均差异有显著性（t=3．020～9．761，P〈0．01）。结论认知行为疗法能有效缓解慢性疼痛、抑郁和焦虑，明显改善患者的生存质量。
Objective To explore the influence of cognitive-behavioral therapy on the quality of life of elderly depression patients with chronic pain. Methods 60 patients were divided into the cognitive-behavioral therapy（CBT） group and non-cognitive-behavioral therapy（N-CBT） group,30 cases in each group. The patients in CBT group were treated with cognitive-behavioral therapy combined with mirtazapine, and the patients in N-CBT group were treated with mirtazapine only. Before treating and after the 4th week and 12th week, depression, anxiety and chronic pain were assessed respectively with Hamilton Depression Scale （HAMD） , Hamilton Anxiety Scale （HAMA） ,and Visual Analogue Scales （VAS）, the quality of life was assessed with the WHO Quality of Life （WHO. QOL-100）. No significant different scores of HAMD, HAMA,VAS and WHOQOL-100 existed between two groups before treatment. Results Depression, anxiety and chronic pain were significantly related to the life quality of elderly depression patients with chronic pain（ r = - 0. 506～- 0. 676, P〈 0.01 ）. At the end of the 12th treating week, the scores of HAMD（ 36.82 ± 7.93 ）, HAMA （ 8.26 ± 3. 13 ）, VAS（ 4.35 ± 0.52 ） and WHOQOL- 100 （ respectively （65.71 ± 17.29）, （ 92.36 ± 13.55 ）, （ 77.91 ± 12.26 ）, （ 78.33 ± 12.81 ）, （ 81.79 ± 12.43 ）, （18.95 ±11. 91 ）, （19.98 ± 11.56 ）） were significantly different fi＇om those before treatment in CBT group, and the ehange of each indicator score was significantly greater in CBT group than those in N-CBT group （ t = 3. 020 9. 761 , P〈 0.01 ）. Conclusion Cognitive-behavioral therapy can effectively improve the life quality of the elderly depression patients with chronic pain.
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2011年第9期830-832,共3页
Chinese Journal of Behavioral Medicine and Brain Science
关键词
认知行为疗法
生存质量
慢性疼痛
老年抑郁症
Cognitive-behavior therapy
Living quality
Chronic pain
Elderly depression
