焦点解决短期心理疗法（SFBT）对抑郁障碍患者心理弹性的影响研究
发布时间：2018-08-02 19:23
【摘要】：目的调查抑郁障碍患者的心理弹性水平,采用资源取向的心理治疗策略,研究焦点解决短期心理疗法(SFBT)对抑郁障碍的心理弹性的影响,为抑郁障碍患者临床路径探索更为有效的临床心理治疗方法。方法1.前测调查研究:选用方便抽样的方式,对80名抑郁障碍住院患者进行问卷调查。使用一般调查问卷、汉密尔顿抑郁量表(HAMD)、心理弹性量表(CD-RISC)进行调查。同时以患者家属和医护人员为正常对照共计70人对其进行问卷调查,采用简版一般调查问卷、心理弹性量表(CD-RISC)。2.心理治疗研究:治疗方法主要为焦点解决短期心理疗法(SFBT),治疗周期2-3周,共6-8次完成;研究对像为80名抑郁障碍患者,单次治疗时间为80分钟。治疗结束时也即患者出院时进行后测评估(短期评估)。3.随访研究:对结束心理治疗满一年的39名抑郁障碍患者进行电话随访。评估患者一年后的服药情况和心理状况,包括生活适应程度、社会功能恢复程度、是否出现过复发以及治疗依从性等,并使用汉密尔顿抑郁量表(HAMD)、心理弹性量表(CDRISC)对其问卷评估。结果1.调查研究结果:(1)抑郁障碍患者心理弹性的得分明显低于健康对照组,差异具有统计学意义(P0.001),其中抑郁障碍患者乐观性、坚韧性、力量性的得分都显著低于健康对照组,差异具备统计学意义(P0.001)。(2)不同既往史的抑郁障碍患者在心理弹性的乐观性维度上的得分差异具有统计学意义(P0.05),人口社会学资料上其余维度均无明显差异(P0.05)。(3)多元回归分析显示,心理弹性中的乐观性对抑郁情绪影响显著(β=-0.374,P0.05,R2=4.6%)。乐观性可以解释抑郁情绪程度的4.6%。2.心理治疗研究结果:(1)HAMD前后测显示,临床路径下心理治疗后,抑郁障碍患者的抑郁情绪显著下降(P0.01)。(2)CD-RISC前后测显示,临床路径下心理治疗后,抑郁障碍患者的心理弹性总分与各维度(乐观性、坚韧性、力量性)得分都显著提升(P0.01)。3.随访研究结果(1)39名接受随访的患者,一年内复发的有4位,复发率为10.3%。(2)回收的34份抑郁障碍患者随访问卷中,一年后其抑郁情绪随访得分较之于后测显著下降(P0.01)。心理弹性得分显著提高,其中心理弹性的坚韧性(P0.01)、乐观性(P0.05)的得分显著提升。结论1.抑郁障碍患者的心理弹性显著低于正常人。2.抑郁障碍患者的心理弹性中的乐观性与抑郁情绪显著负相关,乐观性能够预测患者的抑郁程度,是抑郁障碍患者的重要保护因子。3.抑郁障碍临床路径下联合SFBT能显著提升抑郁障碍患者的心理弹性,降低抑郁水平。4.随访研究证实,抑郁障碍临床路径急性期联合SFBT对抑郁障碍患者的心理弹性的远期疗效显著,且能降低复发率。
[Abstract]:Objective to investigate the level of psychological elasticity in patients with depressive disorder and to study the effect of short-term psychotherapy (SFBT) on the mental resilience of depressive disorder by using a resource-oriented psychotherapy strategy. To explore a more effective clinical psychotherapy for patients with depression. Method 1. Pretest investigation: 80 inpatients with depressive disorder were investigated by convenient sampling. The Hamilton Depression scale (HAMD),) and the Hamilton Depression scale (CD-RISC) were used. At the same time, a total of 70 patients with family members of patients and medical staff as normal control were investigated by using a brief version of the general questionnaire, CD-RISC. 2. Psychotherapy study: the main treatment method was focus solution short term psychotherapy (SFBT),) for 2-3 weeks, complete 6-8 times, and 80 patients with depressive disorder were studied for a single time of 80 minutes. At the end of the treatment, that is, the patient discharged from the hospital for a post-test assessment (short-term assessment). 3. Follow-up study: 39 patients with depressive disorder who had completed psychotherapy for one year were followed up by telephone. To assess the patient's medication and psychological status after one year, including life adaptation, social function recovery, recurrence and treatment compliance, etc. Hamilton Depression scale (HAMD),) was used to evaluate the questionnaire with (CDRISC). Result 1. The results were as follows: (1) the scores of psychological elasticity in patients with depressive disorder were significantly lower than those in the healthy control group (P0.001), and the scores of optimism, tenacity and strength of the patients with depressive disorder were significantly lower than those of the healthy control group. The difference was statistically significant (P0. 001). (2). The scores of depression patients with different history of depression had significant difference in the optimistic dimension of psychological elasticity (P0.05), but there was no significant difference in the other dimensions of demographic and sociological data (P0.05). (3). Optimism in resilience had a significant effect on depression (尾 -0.374N P0.05R24.6%). Optimism explains the degree of depression by 4. 6. 2. The results of psychotherapy were as follows: (1) after HAMD, the depressive mood of the patients with depressive disorder decreased significantly (P0.01). (2) before and after CD-RISC, and after the psychotherapy under the clinical pathway, the depression mood of the patients with depressive disorder decreased significantly (P0.01). (2). The total score of mental elasticity and the scores of each dimension (optimism, tenacity, strength) in patients with depression increased significantly (P0.01) .3. Results: (1) in 39 patients with depression, 4 patients recurred within one year, the recurrence rate was 10.33.2.In 34 patients with depression, the scores of depression were significantly lower after one year (P0.01). The scores of resilience (P0.01) and optimism (P0.05) increased significantly. Conclusion 1. The psychological elasticity of depressive disorder patients was significantly lower than that of normal persons. There is a significant negative correlation between optimism and depression mood in depression disorder patients. Optimism can predict the degree of depression, and it is an important protective factor of depression disorder. Combined with SFBT in the clinical pathway of depression disorder can significantly improve the psychological resilience of patients with depression disorder, reduce the level of depression. 4. Follow-up studies confirmed that the long-term effect of SFBT combined with clinical pathway on depression disorder patients was significant and could reduce the recurrence rate.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.4
本文编号：2160479
[Abstract]:Objective to investigate the level of psychological elasticity in patients with depressive disorder and to study the effect of short-term psychotherapy (SFBT) on the mental resilience of depressive disorder by using a resource-oriented psychotherapy strategy. To explore a more effective clinical psychotherapy for patients with depression. Method 1. Pretest investigation: 80 inpatients with depressive disorder were investigated by convenient sampling. The Hamilton Depression scale (HAMD),) and the Hamilton Depression scale (CD-RISC) were used. At the same time, a total of 70 patients with family members of patients and medical staff as normal control were investigated by using a brief version of the general questionnaire, CD-RISC. 2. Psychotherapy study: the main treatment method was focus solution short term psychotherapy (SFBT),) for 2-3 weeks, complete 6-8 times, and 80 patients with depressive disorder were studied for a single time of 80 minutes. At the end of the treatment, that is, the patient discharged from the hospital for a post-test assessment (short-term assessment). 3. Follow-up study: 39 patients with depressive disorder who had completed psychotherapy for one year were followed up by telephone. To assess the patient's medication and psychological status after one year, including life adaptation, social function recovery, recurrence and treatment compliance, etc. Hamilton Depression scale (HAMD),) was used to evaluate the questionnaire with (CDRISC). Result 1. The results were as follows: (1) the scores of psychological elasticity in patients with depressive disorder were significantly lower than those in the healthy control group (P0.001), and the scores of optimism, tenacity and strength of the patients with depressive disorder were significantly lower than those of the healthy control group. The difference was statistically significant (P0. 001). (2). The scores of depression patients with different history of depression had significant difference in the optimistic dimension of psychological elasticity (P0.05), but there was no significant difference in the other dimensions of demographic and sociological data (P0.05). (3). Optimism in resilience had a significant effect on depression (尾 -0.374N P0.05R24.6%). Optimism explains the degree of depression by 4. 6. 2. The results of psychotherapy were as follows: (1) after HAMD, the depressive mood of the patients with depressive disorder decreased significantly (P0.01). (2) before and after CD-RISC, and after the psychotherapy under the clinical pathway, the depression mood of the patients with depressive disorder decreased significantly (P0.01). (2). The total score of mental elasticity and the scores of each dimension (optimism, tenacity, strength) in patients with depression increased significantly (P0.01) .3. Results: (1) in 39 patients with depression, 4 patients recurred within one year, the recurrence rate was 10.33.2.In 34 patients with depression, the scores of depression were significantly lower after one year (P0.01). The scores of resilience (P0.01) and optimism (P0.05) increased significantly. Conclusion 1. The psychological elasticity of depressive disorder patients was significantly lower than that of normal persons. There is a significant negative correlation between optimism and depression mood in depression disorder patients. Optimism can predict the degree of depression, and it is an important protective factor of depression disorder. Combined with SFBT in the clinical pathway of depression disorder can significantly improve the psychological resilience of patients with depression disorder, reduce the level of depression. 4. Follow-up studies confirmed that the long-term effect of SFBT combined with clinical pathway on depression disorder patients was significant and could reduce the recurrence rate.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.4
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