正念認知干預對雙相情感障礙患者心理健康狀況及生活質量的影響

林小容 林崇光 楊曉麗

[摘要] 目的 探討正念認知干預對雙相情感障礙（BAD）患者心理健康狀況及生活質量的影響。 方法 選擇2016年1月～2017年12月該院精神科就診的BAD患者共100例，隨機分為干預組和對照組。兩組均予以丙戊酸鈉片治療，起始劑量400 mg/d，逐漸加量增至800～1600 mg/d。對照組在藥物治療基礎上采用常規干預措施，干預組再加正念認知干預，兩組均干預12周。觀察兩組干預前后心理健康狀況及生活質量變化，并評估其臨床效果。 結果干預12周后，兩組患者SAS和SDS評分均較干預前明顯下降（P<0.05或P<0.01），且干預組下降幅度較對照組更顯著（P<0.05）;干預12周后，兩組生活質量SF-36評分均較治療前明顯上升（P<0.05或P<0.01），且干預組上升幅度較對照組更顯著（P<0.05）。 結論 正念認知干預BAD患者能明顯的改善患者的心理健康狀況，提高患者的生活質量。

[關鍵詞] 雙相情感障礙;正念認知干預;心理健康狀況;生活質量

[中圖分類號] R749.05? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2019）09-0077-04

[Abstract] Objective To investigate the effect of mindfulness cognitive intervention on mental health status and quality of life in patients with bipolar affective disorder（BAD）. Methods A total of 100 patients with BAD who were admitted to the department of psychiatry in our hospital from January 2016 to December 2017 were selected and randomly divided into intervention group and control group. Both groups were given sodium valproate tablets.The initial dose was 400 mg/d， which was gradually increased to 800-1600 mg/d.The control group was given routine interventions based on drug treatment. The intervention group was further given mindfulness cognitive intervention， and both groups were intervened for 12 weeks. The mental health status and quality of life changes before and after intervention were observed and the clinical effects were evaluated in both groups. Results After 12 weeks of intervention， the SAS and SDS scores of the two groups were significantly lower than those before the intervention（P<0.05 or P<0.01）， and the decrease in the intervention group was more significant than that in the control group（P<0.05）; after 12 weeks of intervention， the quality of life SF-36 scores of the two groups were significantly higher than those before treatment（P<0.05 or P<0.01）， and the increase in the intervention group was more significant than that in the control group（P<0.05）. Conclusion Mindfulness cognitive intervention in the patients with BAD can significantly improve the mental health status of patients and improve their quality of life.

[Key words] Bipolar affective disorder （BAD）; Mindfulness cognitive intervention; Mental health status; Quality of life

雙相情感障礙（Bipolar affective disorder，BAD）是精神科常見疾病之一，具有患病率高、自殺率高和誤診率高等特點[1，2]。BAD可表現為抑郁、焦慮、躁狂等心理問題，目前臨床上對于BAD重視不夠，常誤診為單相抑郁，導致患者病情加重，引起患者社會功能和生活質量下降[3，4]。因此采用有效的藥物和康復干預是改善BAD患者的心理健康和生活質量的關鍵措施[5，6]。正念認知干預是一種應用于情緒調節、壓力緩解的干預措施，近年來逐漸應用于BAD干預治療中[7]。本研究觀察了正念認知干預對雙相情感障礙患者心理健康狀況及生活質量的影響，現報道如下。