心理治療對老年抑郁和焦慮共病患者認知功能的影響*

劉振靜 李 璟 李玉煥中國.山東省青島市精神衛生中心 266034 E-mail:zhenjing1976@163.com 通訊作者 E-mail:yuhuen1967@163.com

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心理治療對老年抑郁和焦慮共病患者認知功能的影響*

劉振靜 李 璟 李玉煥△
中國.山東省青島市精神衛生中心 266034 E-mail:zhenjing1976@163.com △通訊作者 E-mail:yuhuen1967@163.com

【摘 要】目的:探討心理治療對老年抑郁和焦慮共病患者認知功能的影響。方法:將80例老年抑郁和焦慮共病患者按照隨機原則分為研究組40例(心理治療合并抗抑郁藥物治療)和對照組40例(單用抗抑郁藥物治療),療程為8周,采用簡易精神狀態檢查量表(MMSE)、日常生活能力量表(ADL)于治療前及治療第8周末評定療效。結果:經過治療,兩組認知能力及日常生活能力顯著提高。治療后第8周末,研究組MMSE總分顯著高于對照組(t= 2.42,P＜0.05)且ADL總分研究組顯著低于對照組(t=-2.10,P＜0.05)。結論:心理治療能提高老年抑郁和焦慮共病患者的認知功能,提高生活質量。

【關鍵詞】老年病人;共病;抑郁;焦慮;心理治療;認知功能

The Impact of Psychotherapy on Cognitive Function of Older Patients with Comorbidity of Depression and Anxiety

Liu Zhenjing,Li Jing,Li Yuhuan
Qingdao Mental Health Center,Qingdao 266034,China

【Abstract】 Objective:To investigate the impact of psychotherapy on cognitive function of older patients with comorbidity of depression and anxiety.Methods:80 elder patients with comorbidity depression and anxiety were randomly divided into the study group and the control group.The treatment was conducted for 8 weeks.The two groups were measured by Mini-Mental State Examination(MMSE)and activity of daily living(ADL)before treatment and 8weeks after treatment.Results:After treatment,the study group and the control group had significantly improved in cognitive function and activity of daily living.At the 8th week after the treatment,the study group's total score of MMSE showed significant higher than that of the control group(t=2.42,P＜0.05).The study group had lower score of ADL than control group(t=-2.10,P＜0.05).Conclusion:Psychotherapy can improve the cognitive function of older patients with comorbidity of depression and anxiety.

【Key words】Older patients;Comorbidity;Depression;Anxiety;Psychotherapy;Cognitive function

抑郁和焦慮障礙在同一個體共存,即稱為抑郁和焦慮共病(Comorbidity depression and anxiety),資料顯示,有60%～90%的抑郁癥患者伴有焦慮障礙,50%的抑郁癥患者可同時符合焦慮障礙的診斷標準[1]。而老年抑郁癥患者由于生活能力下降、身體疾病較多、喪偶等多種原因,喪失及無助感、無用感增加,抑郁與焦慮障礙共病的發生率更高[2-4]。大量研究顯示,與單一焦慮或抑郁障礙患者相比,抑郁和焦慮共病患者具有癥狀重,病程慢性化,社會功能損害重,自殺率高和預后差等特征,且治療難度大,嚴重影響個體認知功能、正常的學習和交往活動等[5-7]。……