持续性躯体形式疼痛障碍临床药物与心理治疗的研究

目的探索抗抑郁治疗配合认知行为治疗与单用药物治疗的临床疗效的差别。方法对64名持续性躯体形式疼痛障碍患者,追踪观察2年,治疗前将患者分为2组,一组接受氟西汀治疗(简称为药物治疗组),另一组接受氟西汀加认知行为治疗(简称为心理治疗组)。对2组治疗前与后2、4、6周,以及半年、1年、2年的症状评分和HAMD评分比较,以及2年后复发率的对比。结果氟西汀配合认知行为治疗对持续性躯体形式疼痛障碍的治疗,4周和2年时疗效明显优于氟西汀治疗组,HAMD总评分、躯体化症状因子评分与认知障碍因子评分均明显低于单用氟西汀治疗组(P<0.05)。氟西汀配合认知行为治疗2年复发率明显低于单用氟西汀治疗组(P<0.05)。结论抗抑郁治疗配合认知行为治疗是对持续性躯体形式疼痛障碍的更为有效的治疗措施,在一定程度上可以减少持续性躯体形式疼痛障碍复发。     

阿尔茨海默病精神行为症状的治疗

阿尔茨海默病患者除患有认知功能障碍外,多数伴有精神行为症状。针对阿尔茨海默病精神行为症状的治疗包括药物治疗、行为治疗、环境治疗、音乐治疗和电抽搐治疗（ECT）。     

情绪障碍患者的情绪调节

以往对情绪调节的研究大都集中于正常群体,而对情绪障碍患者如焦虑、抑郁等临床患者则关注较少.此外,目前对情绪障碍的治疗主要应用认知行为疗法,但是认知行为治疗模式存在着不足,它们倾向于减弱情绪与思想和行为的联系,而对情绪障碍患者的情绪调节研究为我们思考情绪障碍的治疗带来了新的观点.文章主要从情绪调节的策略、神经机制来说明情绪障碍患者的情绪调节,并探讨了情绪调节对治疗情绪障碍的意义.     

门诊治疗焦虑性心理障碍3例报道

焦虑性障碍是指以病理焦虑情绪为主要临床相的神经症,临床常见的包括：广泛性焦虑症、惊恐障碍、恐怖症、强迫症,以及以慢性焦虑状态为主的创伤后应激障碍,在DSM-IV中统称为焦虑性障碍.一般认为,对于焦虑性障碍,认知行为治疗和药物治疗是两种主要的、经研究证实有效的治疗方法.不过这两种方法都存在不足.大量的随机对照随访研究证实了认知行为治疗的近期和远期疗效,但是认知行为治疗需要大量经严格培训过的心理治疗师,对心理治疗师个人的要求也高,并且需要较长的心理治疗时间.药物治疗的近期疗效尚令人满意,     

生物反馈疗法联合认知行为干预治疗功能性排便障碍的临床疗效分析

【目的】探讨生物反馈疗法联合认知行为干预治疗功能性排便障碍的临床疗效。【方法】选取功能性排便障碍患者50例,分为治疗组26例和对照组24例。治疗组采用生物反馈疗法联合认知行为干预治疗,对照组采用单纯生物反馈治疗。比较两组治疗前后患者便秘症状积分和健康调查简表(SF-36)评分的改善结果;对两组疗效进行临床评定。【结果】治疗组便秘症状积分改善总有效率为92.3%,高于对照组的70.8%(P<0.05)。治疗组健康调查简表评分(SF-36)在社会功能、情感职能、精神健康方面的改善优于对照组(P<0.05)。【结论】生物反馈疗法联合认知行为干预治疗功能性排便障碍能显著改善患者的临床症状和提高其生活质量,值得扩大研究和初步临床推广。     

老年高血压患者睡眠的健康行为干预

目的探讨健康行为干预对老年高血压患者伴失眠问题的干预疗效。方法将108例老年高血压伴失眠患者随机分为治疗组、对照组1和对照组2,在基线分别施行综合认知行为治疗干预、单纯的睡眠卫生教育以及等待行为治疗,并分别在干预前后进行匹兹堡睡眠质量指数评定,以及评估干预后3组间收缩压及脉压指数的差异。结果治疗组干预后PSQI中主观睡眠质量、入睡时间、睡眠效率、睡眠障碍、催眠药物和PSQI总分差异均有统计学意义(P0.05);此外还发现治疗组干预后收缩压和脉压指数比干预前明显降低[(150.83±7.70)mm Hg vs.(145.89±7.72)mm Hg,(0.50±0.04)vs.(0.48±0.36)],差异均有统计学意义(P0.01)。结论老年高血压伴失眠患者通过健康行为的认知干预能改善老年高血压的睡眠障碍,比单纯的睡眠卫生教育更有效;此外认知行为综合治疗使老年高血压睡眠障碍患者的收缩压和脉压指数有所下降。     

认知行为训练治疗儿童注意缺陷多动障碍的研究

目的：探讨认知行为训练对注意缺陷多动障碍（ADHD）儿童的治疗效果。方法：对34例ADHD儿童采用系统化的认知行为训练方案，3个月为1周期。治疗前后分别用Conners量表父母症状问卷（PSQ）和数字划销测验评估，做治疗前后的比较。结果：接受治疗的ADHD儿童在治疗后Conners量表PSQ总分明显降低（P＜0．01），数字划销测验失误率下降，治疗前后比较差异有显著性（P＜0．05），结论：认知行为训练能有效地治疗儿童注意缺陷多动障碍。     

急性期重型精神障碍开放管理的模式

精神疾病患者由于认知、情感、意志、行为等方面有明显障碍,常有危害自身和社会的行为,同时,由于自知力的缺失,大部分患者拒绝治疗.多年以来,对精神疾病患者都采用封闭式强制治疗的方式.     

老年轻度认知功能障碍的影响因素研究与预防对策

老年轻度认知功能障碍是介于正常和老年痴呆的一种中间状态,倘若不给予足够的重视和有效的治疗很可能发展为老年痴呆,造成不可弥补的严重后果。通过对可能引起老年轻度认知功能障碍的若干因素(社会学因素、疾病相关因素、人格因素、行为生活方式因素)进行综述,并提出确切的预防对策,期望能从源头阻止老年轻度认知功能障碍的发生,降低其发病率。     

儿童注意力缺陷多动障碍发生现状与干预对策

注意力缺陷多动障碍(ADHD)是儿童时期最为常见的行为疾病之一,ADHD儿童主要存在以注意力障碍为特征的认知功能缺陷,主要表现为与其年龄不相适应的注意力不集中、多动和冲动行为,并伴有学习障碍、品行障碍、情绪障碍等多种认知缺陷。其发病原因与有害重金属的影响、不良饮食习惯的影响、不良教育方式的影响、遗传等因素的影响有关。ADHD的发生并不是单一因素引起的,而是以上多种因素相互影响、综合作用的结果。因此,在对ADHD儿童干预治疗时应考虑到多因素、多方面立体化干预,可采用膳食营养干预、医教结合干预、社会心理干预、感统训练干预、行为干预、音乐治疗干预等综合干预措施。     

The use of cognitive-behavioral therapy in the University of Minnesota's outpatient psychiatry clinic

Cognitive-behavioral therapy (CBT) refers to a group of therapeutic techniques that can be categorized broadly as psychoeducation, cognitive restructuring, and behavioral exposure. Unlike other psychotherapeutic approaches, CBT is derived from learning laboratory experimentation rather than conjecture and theorizing. This article provides background information concerning the origins and practice of cognitive and behavioral therapies and summarizes findings from a recently completed research project at the University of Minnesota that integrates new neuroscientific findings and CBT.     

The treatment of bulimia nervosa in patients with diabetes mellitus

This paper describes the treatment of a series of patients with bulimia nervosa who also had insulin-dependent diabetes mellitus. The aim was to discover what modifications to an established cognitive behavioral treatment for bulimia nervosa proved necessary to accommodate the presence of diabetes. Treatment of the patients proved more difficult than that of comparable nondiabetic patients. Possible reasons for the difficulties encountered are discussed, together with strategies for overcoming them. It is concluded that cognitive behavior therapy can be successfully modified for the treatment of such patients, although adjunctive psychological and physical treatment techniques are required in some instances. Treatment usually results in improvement in both eating habits and glycemic control, and is likely to reduce the risk of future diabetic complications. This paper describes the treatment of a series of patients with bulimia nervosa who also had insulin-dependent diabetes mellitus. The aim was to discover what modifications to an established cognitive behavioral treatment for bulimia nervosa proved necessary to accommodate the presence of diabetes. Treatment of the patients proved more difficult than that of comparable nondiabetic patients. Possible reasons for the difficulties encountered are discussed, together with strategies for overcoming them. It is concluded that cognitive behavior therapy can be successfully modified for the treatment of such patients, although adjunctive psychological and physical treatment techniques are required in some instances. Treatment usually results in improvement in both eating habits and glycemic control, and is likely to reduce the risk of future diabetic complications. This paper describes the treatment of a series of patients with bulimia nervosa who also had insulin-dependent diabetes mellitus. The aim was to discover what modifications to an established cognitive behavioral treatment for bulimia nervosa proved necessary to accommodate the presence of diabetes. Treatment of the patients proved more difficult than that of comparable nondiabetic patients. Possible reasons for the difficulties encountered are discussed, together with strategies for overcoming them. It is concluded that cognitive behavior therapy can be successfully modified for the treatment of such patients, although adjunctive psychological and physical treatment techniques are required in some instances. Treatment usually results in improvement in both eating habits and glycemic control, and is likely to reduce the risk of future diabetic complications.     

早期认知-行为干预对冠心病介入治疗患者心功能及自我管理能力的影响

目的 观察早期认知-行为干预对冠心病介入治疗患者心功能及自我管理能力的影响。方法 将2019年2月至2021年2月于我院接受介入治疗的100例冠心病患者随机分为观察组与对照组各50例。对照组予以常规护理,观察组在对照组基础上实施早期认知-行为干预。对比两组的心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及左室后壁厚度(LVPWd)]、自我管理能力。结果 护理后,观察组的LVEF高于对照组, LVEDD、 LVPWd低于对照组(P<0.05)。护理后,观察组症状管理、角色功能、情绪控制、沟通能力评分均高于对照组(P<0.05)。结论 早期认知-行为干预可显著改善冠心病介入治疗患者心功能状态与自我管理能力,促进其病情恢复,值得临床推广应用。     

社区居民压力管理技术的自助化研究

回顾了近5年的文献,比较分析不同取向的心理干预技术的操作方法,并将复杂难懂的理论方法进行自助化的改进.如认知取向的认知疗法、合理情绪疗法、心理支持疗法的自助化,可以通过对自身的自动性思维进行及时记录和纠正,准确识别不合理信念,努力获得身边家人朋友的支持等方式加以实现.行为取向的压力管理技术也可通过借助伴奏带中的指导语、生活伙伴之间的帮助或只依靠自己,即可实现认知行为疗法、渐进性肌肉放松、音乐放松、冥想和自我催眠法的自助式使用.随着各种压力管理技术的整合和自助化,各种取向的心理学技术将更加广泛地推广开来,成为疏解社区居民心理压力的有效工具,切实提高社区居民的心理健康水平.     

高频重复经颅磁刺激联合认知行为治疗对脑卒中后焦虑和抑郁共病状态患者的影响

目的观察高频重复经颅磁刺激(rTMS)联合认知行为治疗对脑卒中后焦虑(PSA)、脑卒中后抑郁(PSD)共病状态患者的影响。 方法采用随机数字表法将160例脑卒中后焦虑抑郁状态患者分为对照组和观察组。两组患者均给予脑卒中常规治疗、抗抑郁药物治疗和认知行为治疗,对照组同时给予高频rTMS假刺激治疗,观察组则给予高频rTMS真刺激治疗。观察4周后2组患者抑郁症状、焦虑症状、睡眠质量、日常生活能力改善情况。 结果两组患者汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、匹兹堡睡眠指数量表(PSQI)、改良Barthel指数(MBI)在治疗前差异无统计学意义(P均>0.05)。治疗4周后,对照组和观察组的HAMD评分、HAMA评分、PSQI较治疗前下降,差异有统计学意义(P均<0.05),其中观察组下降更为明显,与对照组相比,差异有统计学意义(P<0.05)。对照组和观察组MBI与治疗前相比,均有明显提高,差异有统计学意义(P<0.05),而观察组和对照组相比,观察组分数提高更显著,差异有统计学意义(P<0.05)。观察组治疗有效率为87.50%,高于对照组的71.25%。两组之间差异有统计学意义(Uc＝－3.45,P<0.001)。 结论高频rTMS治疗联合认知行为治疗和认知行为治疗均能有效改善PSA+PSD患者的焦虑抑郁症状、睡眠质量及日常生活能力,但高频rTMS治疗联合认知行为治疗的效果更加明显。     

认知行为治疗对老年抑郁症疗效的研究

目的探讨认知行为治疗在抑郁症中的作用。方法将44例抑郁症患者随机分为研究组和对照组,对照组采用单纯药物治疗,研究组在药物治疗同时联合认知行为疗法,两组分别于观察前及治疗8周后进行Hamilton抑郁量表(HAMD),评定抑郁症患者的心理状况。结果两组Hamilton评分前后分别比较差异有显著(P<0.05),研究组部分项目Hamilton评分改善更显著(P<0.05)。结论药物治疗联合认知行为治疗可更有效地改善抑郁症患者预后。     

Cognitive behavioral therapy and physical exercise for climacteric symptoms in breast cancer patients experiencing treatment-induced menopause: design of a multicenter trial

Background  

Premature menopause is a major concern of younger women undergoing adjuvant therapy for breast cancer. Hormone replacement therapy is contraindicated in women with a history of breast cancer. Non-hormonal medications show a range of bothersome side-effects. There is growing evidence that cognitive behavioral therapy (CBT) and physical exercise can have a positive impact on symptoms in naturally occurring menopause. The objective of this study is to investigate the efficacy of these interventions among women with breast cancer experiencing treatment-induced menopause.     

Emerging research on the treatment of Gulf War veterans' illnesses.

Much of what is known about Gulf War veterans' illnesses is a result of the investment in research by the federal government. Since 1993, the Research Working Group of the Federal Interagency Persian Gulf Veterans Coordinating Board has guided the federal research program. Based on this research, Hodgson and Kipin conclude that the symptom-based conditions reported by Gulf War veterans could be treated through the use of a technique called cognitive behavioral therapy. This past year, the Department of Veterans Affairs launched the largest multisite, randomized, controlled treatment trial of the effectiveness of exercise and cognitive behavioral therapy in relieving the symptoms of ill Gulf War veterans. Despite this important step forward, the Department and its Research Working Group partners continue to explore all aspects of Gulf War veterans' illnesses.     

Psychosocial and Clinical Outcomes of a Cognitive Behavioral Therapy for Asians and Pacific Islanders with Type 2 Diabetes: A Randomized Clinical Trial

Asian Americans and Pacific Islanders are twice as likely to be diagnosed with type 2 diabetes compared to Caucasians. The objective was to determine the effect of cognitive behavioral therapy on quality of life, general health perceptions, depressive symptoms, and glycemia in Asians and Pacific Islanders with type 2 diabetes. The design was a randomized controlled clinical trial comparing cognitive behavioral therapy to diabetes education and support for six weekly sessions. Participants were recruited from two endocrinology practices; 207 were enrolled. The cognitive behavioral therapy group was provided self-management tools which included biofeedback, breathing exercises, and stress relievers, while the diabetes education and support group included diabetes education and group discussions. Assessments of psychosocial and clinical outcomes were obtained before and after sessions and 12 months PostSession. Differences between the two groups were examined using linear mixed-effects models with linear contrasts. The cognitive behavioral therapy group had improved depressive symptom scores from PreSession to EndSession compared to the diabetes education and support group (P < .03), but the improvement did not extend to 12 months PostSession. Similar results were observed with misguided support scores in the Multidimensional Diabetes Questionnaire (P < .03) and susceptibility in health beliefs (P < .01), but no significant differences in HbA1c improvement were found between the two groups. Both interventions improved outcomes from baseline but were not sustained for 1 year.