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短程强化门诊干预项目对双相障碍患者功能水平的影响 被引量:4

The impact of intensive outpatient program on bipolar disorder patients' function
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摘要 目的:探讨短程强化门诊心理干预项目(intensive outpatient program,IOP)对新近缓解(近4个月有1次急性发作,目前处于缓解期)的双相障碍患者功能的影响。方法:将双相障碍患者按本人意愿分为干预组34例(常规药物治疗合并IOP)和对照组19例(常规药物治疗),干预组进行为期4周共10次IOP干预,对照组仅接受常规药物治疗。使用席汉残疾量表(SDS)和大体功能量表(GAF)分别在基线、治疗结束和3个月末随访评估患者功能水平,使用重复测量方差分析进行统计并对两组进行比较。结果:两组SDS和GAF评分在基线、治疗结束和3个月末随访时组间比较,差异无统计学意义(t=-0.05~1.57,P均>0.05)。重复测量方差显示,仅SDS家庭生活、效率低下天数和GAF时间主效应显著[F(2,44)=5.93,P=0.005;F(2,46)=5.05,P=0.01;F(2,48)=91.48,P<0.001],其余均不显著。结论:短程IOP对新近缓解双相障碍患者的功能改善不显著,有待延长随访期进一步评估其长期影响。 Objective: To explore the impact of intensive outpatient program( IOP) on the function of patients with bipolar disorder who had one acute mood episode within 4 months but got remission now. Method:Nineteen patients were distributed into control group( treat as usual,TAU) and 34 patients were signed into intervention group( TAU plus IOP) according to their preference. Patients in intervention group received 10 sessions of IOP intervention within 4 weeks,while control group only received medication therapy as usual. Sheehan disability scale( SDS) and global assessment of functioning scale( GAF) were used to assess the function of patients with bipolar disorder at baseline,after treatment and follow-up for 3 months after treatment. Repetitive measure analysis of variance( ANOVA) was used for data analysis. Results: There were no significant differences of functional levels between intervention group and control group in SDS and GAF neither at baseline,after treatment or follow-up for 3 months after treatment( t =-0. 05 - 1. 57,all of P〉0. 05). Results of repeated ANOVA showed that only main effect of time was significant in sub-scale of family life/home responsibilities and days under productive in SDS,and GAF( F( 2,44) =5. 93,P =0. 005; F( 2,46) =5. 05,P =0. 01; F( 2,48) =91. 48,P〈0. 001).Conclusion: The impact of IOP on the function of patients with bipolar disorder who got remission recently was not significant in short-term follow-up. Prolonged follow-up was needed to determine the long-term effect.
作者 吴丹萍 苑成梅 孙霞 王勇 卢卫红 薛莉莉 黄佳 吴志国 叶尘宇 王宇 宋蕊 方贻儒 WU Dan-ping;YUAN Cheng-mei;SUN Xia;WANG Yong;LU Wei-hong;XUE Li-li;HUANG Jia;WU Zhi-guo;YE Cheng-yu;WANG Yu;SONG Rui;FANG Yi-ru(Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,Chin)
出处 《临床精神医学杂志》 2018年第3期149-153,共5页 Journal of Clinical Psychiatry
基金 科技部“十二五”国家科技支撑项目(2012BAI01B04) 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) 上海市卫计委面上项目(201440327)
关键词 双相障碍 功能 强化门诊心理干预 bipolar disorder function intensive outpatient program
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