短期集体心理治疗对焦虑症患者防御方式及临床疗效的影响

目的 探讨短期集体心理治疗对焦虑症患者疗效的影响,及焦虑症的发生与防御方式的关系.方法 研究对象为符合CCMD-3及DSM-IV的焦虑症患者,共43例.进行汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、防御方式问卷、症状自评量表、SCL-90测评.结果 HAMD评分及HAMA减分值主角组焦虑症患者[(7.82±3.66)分,(14.00±4.52)分]和非主角组焦虑症患者[(5.45±3.05)分,(11.09±4.06)分]显著高于对照组[(1.25±1.05)分,(1.75±0.98)分](P＜0.01).主角组焦虑症和非主角组焦虑症患者的HAMD、HAMA减分值差异无显著性(t=1.648,P=0.115;t=1.589,P=0.128), 但其治疗后的HAMD分[(8.05±3.43)分]、HAMA分[(9.91±4.58)分]、SCL-90中的抑郁[(2.11±0.737)分]、焦虑[(2.10±0.96)分]和其他分[(1.88±0.62)分]较治疗前[(14.68±1.67)分,(22.45±2.46)分,(2.63±0.75)分,(2.73±0.94)分,(2.33±0.85)分]显著降低(t=8.896,P=0.000;t=13.230,P=0.000;t=2.364,P=0.026;t=2.091,P=0.046; t=2.177,P=0.039),不成熟防御因子与抑郁、敌对、精神病性显著性相关(r= 0.489,r=0.414,r=0.463).结论 心理治疗对焦虑有明显疗效,但主角组焦虑症和非主角组焦虑症患者的疗效差异无显著性,焦虑症状与防御方式的不成熟有关.

Study of short-term group psychotherapy and defense style on anxiety disorder patients

Objective To explore effect of short-term group psychotherapy on anxiety disorder patients, and relation of anxiety disorder and the defense styles. Methods All patients meet CCMD-3 and DSM-IV diagnostic criteria for anxiety disorder, 74 anxiety disorder patients were assessed with HAMD, HAMA, Defensive Style Question (DSQ), the symptom checklist 90 (SCL-90). Results Decrease scores of HAMD and HAMA in leading roles (7.82±3.66, 14.00±4.52) and non-leading group (5.45±3.05, 11.09±4.06) were significant higher than that in control group (1.25±1.05, 1.75±0.98) (P＜0.01). No significant difference were found in decrease scores of HAMD and HAMA between 22 leading roles and 21 non-leading anxiety disorder patients (t=1.648, P=0.115; t=1.589, P=0.128), scores of HAMD (8.05±3.43), HAMA (9.91±4.58), depression (2.11±0.737), anxious (2.10±0.96), and other (1.88±0.62) in SCL-90 were significant lower after psychotherapy than before psychotherapy (14.68±1.67, 22.45±2.46, 2.63±0.75, 2.73±0.94, 2.33±0.85) on anxiety disorder patients (t=8.896, P=0.000;t=13.230, P=0.000;t=2.364, P=0.026;t=2.091, P=0.046;t=2.177, P=0.039), Anxious, depression and Ps in SCL-90 were significant related to the defect of the immature defense styles (r=0.489, r=0.414, r=0.463).Conclusion No significant difference were found in treatment effect between 22 leading roles and 21 non-leading anxiety disorder patients but short-term group psychotherapy was obviously efficient on anxiety disorder patients. Anxiety symptom related to the defect of the immature defense styles.