认知疗法对脑卒中后抑郁和认知障碍的疗效观察

目的 用认知疗法指导心理护理并观察PSD（脑卒中后抑郁障碍）患的临床疗效。方法 用SDS（Zung氏抑郁自评量表）和MMSE（简易智力状态检查）对符合CCMD－Ⅱ-R（中国精神疾病分类方案与诊断标准）诊断的脑卒中患评定抑郁和认知障碍。入选41例患随机分为实验组（20例）和对照组（21例）。治疗期间两组患均给予帕罗西汀20mg每晨口服。实验组患采用认知疗法指导心理护理。治疗1个月后对两组患进行临床疗效评估。结果 实验组临床痊愈数明显多于对照组;两组SDS评分明显低于治疗前,但实验组SDS评分治愈数明显多于对照组;两组MMSE评分明显高于治疗前,两组间无差异。结论 用认知疗法指导心理护理对PSD患可提高临床疗效和改善抑郁状态。

Cognitive Therapy on Depression and Cognitive Disfunction after Stroke

Objective To observe the clinical effect of cognitive therapy on poststroke depression (PSD), who received psychological nursing. Methods The depressive condition and cognitive function of the patients after stroke were evaluated by CCMD-II-R ,SDS and MMSE. The 41 patients were randomly divided into the experimental group ( n = 20) and the control group ( n =21). Par-oxetine (20mg qd) was given to both groups. The experimental group received psychological nursing with cognitive therapy. The clinical effect was evaluated between the two groups after one month. Results After one month the number of clinical recovery cases in the experimental group was much greater than that of the control group;SDS scores of both groups decreased significantly, and SDS scores of the experimental group were much higher than those of the control group; MMSE scores of both groups increased markedly, without significant difference between the two groups. Conlusion These results suggest that psychological nursing with cognitive therapy can significantly improve the clinical effect and depressive condition of PSD.