团体认知行为疗法治疗失眠障碍疗效的Meta分析

目的 系统评价团体认知行为疗法（GCBT）治疗失眠患者的临床疗效及其后期效应。 方法 检索EMbase、Cochrane Library、Medline、中国知网和万方数据库,查找符合纳入标准的随机对照 研究,GCBT组患者接受团体认知行为治疗,内容主要包括睡眠卫生宣教、认知治疗、放松训练、睡眠限 制和刺激控制;对照组患者接受安慰剂治疗、健康生活教育、常规护理、等待治疗等。提取睡眠日记中 入睡潜伏期、入睡后觉醒时间、总睡眠时间和睡眠效率,以及睡眠严重程度指数和匹兹堡睡眠质量指数 问卷,并采用RevMan5.3和STATA15.1软件进行Meta分析。结果 最终纳入11篇文献,共计814 例患者, 其中 GCBT 组441 例,对照组373 例。Meta 分析结果显示：GCBT 组入睡潜伏期（WMD=-15.06,95%CI： -19.06～-11.05,P＜ 0.05）、入睡后觉醒时间（WMD=-34.95,95%CI：-49.96～-19.93,P ＜ 0.05）、失眠 严重程度指数（WMD=-6.13,95%CI：-8.04～-4.22,P＜ 0.05）、匹兹堡睡眠质量指数评分（WMD=-2.49, 95%CI：-4.11～-0.87,P＜ 0.05）均低于对照组,睡眠效率高于对照组（WMD=10.46, 95%CI：6.89～14.03, P＜ 0.05）,两组总睡眠时间差异无统计学意义（P＞ 0.05）。早期随访时,GCBT组入睡后觉醒时间 （WMD=-32.51,95%CI：-58.61～ -6.41,P ＜ 0.01）、失眠严重程度指数（WMD=-6.01,95%CI：-8.40～ -3.62,P＜ 0.05）、匹兹堡睡眠质量指数评分（WMD=-4.33,95%CI：-7.06～-1.59,P＜ 0.05）均低于对照 组（均P＜ 0.05）,总睡眠时间（WMD=0.32,95%CI：0.10～0.54,P＜ 0.05）、睡眠效率（WMD=10.51, 95%CI： 5.99～15.02,P＜ 0.05）均高于对照组（均P＜ 0.05）,两组入睡潜伏期差异无统计学意义（均P＞ 0.05）。长 期随访时,GCBT 组睡眠效率高于对照组（WMD=5.30,95%CI：1.61～8.98,P＜ 0.05）,匹兹堡睡眠质量指 数评分低于对照组（WMD=-2.80,95%CI：-3.82～-1.78,P＜ 0.05）,两组的入睡潜伏期、入睡后觉醒时间 及总睡眠时间差异均无统计学意义（均P ＞ 0.05）。结论 GCBT对失眠障碍患者的临床疗效可靠,且在 后期随访中仍持续有效,但其疗效会随着时间推移而下降。     

计算机化和网络认知行为疗法在失眠症中的应用进展

认知行为治疗是失眠症最有效的治疗方法之一,但传统面对面的认知行为疗法存在空间限制、经济负担大等局限。计算机化和网络认知行为疗法是创新性的网络化互动疗法,凭借简便、经济等优势,提高了认知行为疗法的可用性和可接受性。现将对计算机化和网络认知行为疗法的理论基础、核心技术、治疗设置、治疗平台、评估指标、治疗效果和优势及局限性进行综述和介绍,为失眠症的治疗提供参考。     

慢性失眠症认知行为治疗研究进展

慢性失眠症的治疗方式主要包括药物治疗和认知行为治疗.药物治疗慢性失眠症起效时间短、见效快,但易增加成瘾性,产生不良反应.认知行为疗法（CBT）是应用最广泛的非药物治疗方法,现已用于慢性失眠症的治疗并取得显著的疗效.CBT在治疗慢性失眠症的同时避免了药物治疗的不良反应,并且长期治疗效果优于药物治疗.     

抗抑郁药物联合短程团体认知行为疗法治疗强迫症临床观察

目的探讨抗抑郁药物联合短程团体认知行为疗法治疗强迫症的临床疗效。方法将201例强迫症患者采用随机数字表法分为研究组101例及对照组100例。治疗前后分别采用YaleBrown强迫症量表(Y-BOCS)及汤旦林生活质量量表评定两组患者的强迫症状及生活质量。结果治疗后两组Yale-Brown强迫症量表评分显著低于治疗前(P0.01),研究组显著低于对照组(P0.01);两组汤旦林生活质量量表评分显著高于治疗前(P0.01),研究组显著高于对照组(P0.01)。治疗后研究组汤旦林生活质量量表身体方面、心理方面、社会方面、尽职的能力、自我健康意识评分均显著高于对照组(P0.01)。结论抗抑郁药物联合短程认知行为团体治疗可有效改善强迫症患者的强迫症状,提高生活质量,值得推广应用。     

乌灵胶囊与认知行为疗法对非器质性失眠症的疗效评价

目的 分别对非器质性失眠症受试者进行药物治疗以及认知行为治疗,比较两组受试者的疗效.方法 将100名非器质性失眠症受试者随机分为两组,一组用乌灵胶囊治疗,另一组用认知行为治疗（CBT）,疗程4周,治疗后第1个月（随访期Ⅰ）和第2个月（随访期Ⅱ）进行随访.使用匹兹堡睡眠指数量表（PSQI）,通过治疗前后减分情况及有效率进行疗效评价.结果 与治疗前相比,治疗后PSQI总分下降明显,前后比较差异有统计学意义（P〈0.01）,两组之间差异无统计学意义（P〉0.05）;治疗4周、随访期Ⅰ和随访期Ⅱ的有效率,乌灵胶囊组分别是66.7%、58.4%和60.4%;认知行为组分别是69.2%、71.8%和74.4%,差异无统计学意义（P〉0.05）.结论 乌灵胶囊和认知行为疗法对非器质性失眠症疗效相当.     

认知行为疗法治疗12例神经性厌食症的效果分析

神经性厌食症是与心理因素密切相关的疾病。它因节食、拒食行为而导致体重下降,月经紊乱等,重者可衰竭、死亡［１］。本文对神经性厌食症应用认知行为疗法治疗作一分析,现报道如下。１资料与方法病例来源于本院住院治疗的神经性厌食症共１２例,均符合ＣＣＭＤ—２—Ｒ...     

失眠症的认知-行为治疗进展

本文对失眠症认知-行为治疗的进展做一综述。     

惊恐障碍的认知行为疗法研究进展

对惊恐障碍的认知行为疗法国内外研究进展作一综述。     

认知行为疗法对慢性精神分裂症患者强迫症状的效果研究

目的探讨认知行为疗法对慢性精神分裂症患者强迫症状的干预效果。方法将65例伴有强迫症状的慢性精神分裂症患者随机分为研究组（33例）和对照组（32例）,研究组接受共6个月的认知行为疗法,并在基线,干预后3月末,6月末应用耶鲁-布朗强迫量表（Y-BOCS）、汉密尔顿焦虑量表（HAMA）评定疗效。结果干预后6月末,研究组和对照组的Y-BOCS评分以及HAMA评分较干预前均有显著性降低（P〈0.05）。而在干预后3月末,6月末,研究组的Y-BOCS评分和HAMA评分均显著低于对照组,且差异均有统计学意义（P〈0.05）。结论认知行为疗法可有效改善慢性精神分裂症患者的强迫症状。     

认知行为疗法对首发精神分裂症疗效观察

目的:观察认知行为疗法对首发精神分裂症的临床疗效.方法:将首发精神分裂症患者177例,随机分为有无认知行为疗法两组.用简明精神病评定量表(BPRS)、自知力量表(insight scale)、功 能大体评定量表(GAF)、副反应量表(TESS)分别于入组前、治疗第2、4、8周末各评定1次,并比较两组住院时间、90项症状清单(SCL-90)总分.结果:研究组(有认知行为治疗)在治疗第4、8周末BPRS、insightscale、GAF评分较对照组(无认知行为治疗)改变显著.结论:早期认知行为疗法干预能明显改善首发精神分裂症临床症状,缩短住院时间.     

Residual sleep beliefs and sleep disturbance following Cognitive Behavioral Therapy for major depression

Background: Sleep disturbance is a commonly reported residual symptom after effective depression treatment. This residual sleep impairment, as well as the presence of problem levels of certain sleep beliefs, may be important for depressive relapse prevention, and as such should be addressed in treatment. The following study examined residual sleep disturbance and residual maladaptive sleep beliefs in those treated with Cognitive Behavior Therapy for depression. Methods: Participants (N = 24) were clinic patients seeking treatment for depression at a community clinic. Repeated measures analyses of variance tested pre‐ to posttreatment change on depression symptoms, general negative beliefs, sleep quality, and maladaptive sleep beliefs. Results: As expected, significant time effects were found for depressive symptoms and general negative beliefs. Sleep quality scores also decreased significantly at posttreatment; however, 92% of those no longer meeting depressive criteria continued to endorse residual sleep disturbance, according to an established clinical cutoff score of >5 on a validated measure of sleep quality (the Pittsburgh Sleep Quality Index). There were no significant pre‐ to posttreatment changes for maladaptive sleep beliefs. Conclusions: The results indicate that sleep disturbance and maladaptive sleep‐related beliefs remain a problematic residual symptom of remitted depression. These findings are discussed with reference to improving cognitive behavioral treatments for depression in order to help reduce rates of residual sleep problems. Depression and Anxiety, 2011. © 2011 Wiley‐Liss, Inc.     

Effectiveness of Cognitive Behavioral Therapy for Veterans with Depression and Suicidal Ideation

The current study examined suicidal ideation (SI) and depression outcomes among Veterans receiving Cognitive Behavioral Therapy for depression (CBT–D) throughout the Department of Veterans Affairs health care system. Patient outcomes included Beck Depression Inventory–II total score and SI item. Of 902 patients, 427 (47%) had no SI, 405 (45%) had SI but no suicidal intent, 26 (3%) indicated suicidal desire, 8 (1%) indicated suicide intent if they had the chance, and 36 (4%) did not answer this question at session one. The odds of SI decreased by 64% from 1.03 at session one to 0.37 at final assessment (OR = 0.36; 95% CI: 0.31, 0.43). Findings reveal that CBT–D was associated with significant decreases in SI and depression among Veterans.     

Individual Cognitive Behavioral Intervention for Anger

There is growing evidence for the efficacy of programs to reduce inappropriate aggression in people with intellectual disabilities. These have been provided in groups and for individuals in forensic settings. People with intellectual disability and inappropriately expressed anger who were referred to a community psychology service were assigned to either individual intervention or a waiting list control. Participants were assessed both before and after treatment using an anger provocation inventory. Improvements were found in the scores obtained on the Anger Inventory for those receiving individual treatment when compared with the control group using a 2-by-2 split plot Analysis of Variance (ANOVA). These results suggest that individual cognitive behavioral intervention may be an effective treatment option in community settings.     

A Cognitive Behavioral Systems Approach to Family Therapy

Family therapy, including conjoint approaches to couples, families, and parent-child dyads, is infused with concepts adapted from general systems theory. Many of the most popular models during the period when family therapy flourished in the 1960s and 1970s directly incorporated systems theory. As modifications and new approaches came into vogue in the 1980s and 1990s, the contributions of systems concepts were eclipsed and theorists, researchers, and practitioners often failed to acknowledge their contribution. In an attempt to re-integrate these developments in state-of-the-art family therapy, this article will explore systems theory, its complementary characteristics with cognitive behavioral therapy, and how these 2 approaches can be simultaneously applied to family therapy in a comprehensive, integrative manner. The distinctions between cognitive therapy, behavioral therapy, and (combined) cognitive behavioral therapy will be delineated; after which cognitive behavioral therapy interventions and their relationship to systems concepts will be described. An illustrative model will be presented with recommendations for future research.     

Comparative Effectiveness of Mind-Body Exercise Versus Cognitive Behavioral Therapy for College Students with Problematic Smartphone Use: A Randomized Controlled Trial

Purpose: The purpose of the present study was to compare the effectiveness of mind-body exercise (ME) and cognitive behavioral therapy (CBT) on addiction level and psychological well-being among college students with problematic smartphone use (PSU). Methods: A 12-week randomized controlled study was carried out at a university in central China. A total of 95 PSU college students who met the inclusion criteria were randomly assigned to a ME group (ME, n = 31), CBT group (CBT, n = 30), or control group (CG, n = 34). Both ME intervention and CBT, twice per week for 90 min per session, lasting for 12 weeks were administered by a certified therapist respectively. Participants in the CG group were asked to maintain their original lifestyle. Results: A significant reduction in addiction level (p < 0.001 for ME vs. CBT; p < 0.001 for ME vs. CG), loneliness (p < 0.001 for ME vs. CG), anxiety (p < 0.001 for ME vs. CG; p < 0.001 for CBT vs. CG) was found. Only significant stress reduction was observed in ME and CBT between baseline and Week 12 (ps < 0.001). Conclusions: ME and CBT (mainstream psychotherapy) may effectively overcome PSU of college students, and reduced the level of smartphone addiction, loneliness, anxiety, and stress. Furthermore, as a culture-specific, low-cost, and readily accessible training program with multiple components (gentle movement, anatomic alignment, mental focus, deep breathing, and meditative state of mind that is similar to mindfulness emphasizing noncompetitive, present-moment, and nonjudgmental introspective component), ME seems to be superior to CBT in terms of PSU.