摘要
目的探究团体认知行为治疗对双相障碍患者病耻感和服药依从性的影响。方法25例患者根据配对设计分为研究组16例和对照组9例，研究组在常规治疗基础上接受团体认知行为治疗，对照组接受常规治疗，采用精神疾病病耻感量表（ISMI）和药物依从性评价量表（MARS）测评病耻感和服药依从性。结果10次治疗后，两组患者病耻感组间比较，研究组较对照组刻板印象的认可因子改善明显，差异有统计学意义（P〈0．05）；组内比较，研究组疏远因子、刻板印象的认可因子、歧视经历因子和病耻感总分优于治疗前，差异有统计学意义（P〈0．05），而对照组总分及各因子分治疗前后比较差异均无统计学意义（P〉0．05）。两组患者服药依从性组间比较，两组治疗前后差异均无统计学意义（P〉0．05）；组内比较，研究组服药依从性优于治疗前，差异有统计学意义（P〈0．05），而对照组差异无统计学意义（P〉0．05）。结论团体认知行为治疗可降低双相障碍患者的病耻感，提高服药依从性，对促进疾病的康复具有重要意义。
Objective To study the effects of group cognitive behavioral therapy on stigma and medication compliance in patients with bipolar disorder. Methods Totals of 25 patients with bipolar disorder were divided into study group （16 cases） and control group （9 cases） by paired design. The study group received group cognitive behavioral therapy on the basis of routine treatment. While the control group received routine treatment. Internalized Stigma of Mental Illness scale （ISMI） and Medication Adherence Rating Scale （MARS） were measured in two groups. Results In stigma, after 10 sessions, stereotype endorsement improved significantly in the study group （P 〈 0.05）. Alienation, stereotype endorsement, perceived discrimination and total scores of ISMI improved statistically after treatment within the study group （P 〈 0.05）. While within the control group, scores of ISMI and subscales showed no significant differences before and after treatment （P 〉 0.05）. In the medication compliance, there were no significant differences between two groups before and after treatment （P 〉 0.05）. The scores of MARS improved statistically within the study group after treatment （P 〈 0.05）. While within the control group, scores of MARS showed no significant difference before and after treatment （P 〉 0.05）. Conclusions Group cognitive behavioral therapy can reduce stigma, improve medication compliance and promote rehabilitation for patients with bipolar disorder.
出处
《神经疾病与精神卫生》
2017年第2期93-97,102,共6页
Journal of Neuroscience and Mental Health
基金
科技部“十二五”国家科技支撑项目（2012BA101804）
国家自然科学基金委员会重大研究计划“情感和记忆的神经环路基础”培育项目（91232719）
国家临床重点专科-上海市精神卫生中心（卫生部医政司2011-873）
上海市申康发展中心“适宜技术联合开发推广应用项目（SHDC12016205）
上海市科委医学引导项目（124119a8602）
上海交通大学“医工交叉研究基金”面上项目（YG2011MS37）
上海市卫生局公共卫生海外留学人才项目（GWHW201202）
关键词
双相情感障碍
病耻感
服药依从性
团体认知行为治疗
Bipolar disorder
Stigma
Medication compliance
Group cognitive behavioral therapy
