拉莫三嗪合并认知行为治疗对双相抑郁患者临床疗效研究

目的探讨认知行为治疗联合拉莫三嗪治疗双相抑郁患者的临床疗效。方法将研究对象随机分为治疗组和对照组，在药物治疗的基础上治疗组给予认知行为治疗，而对照组给予一般心理支持。测定入组基线及治疗第1、3、5及8周汉密尔顿抑郁量表（HAMD17）积分、治疗前后应付方式积分，计算两组临床总有效率、HAMD17减分率、因子分变化及应付方式积分变化。结果两组治疗方案的总体疗效相当（χ2=0．0934，P〉0．05），且HAMD17积分均在第3周明显降低，说明两组起效时间相同（P〉0．05）；但治疗组在认知障碍、迟滞因子的改善上显著优于对照组（P〈0．05），能更有效的改善幻想、求助因子积分（P〈0．05）。结论认知行为治疗能显著改善双相抑郁患者应付方式，重视应付方式等人格因素可能是双相抑郁预防复发的重要方面。

Clinical effect of cognitive behavioral therapy with lamotrigine for patients with bipolar depression

Objective To study the clinical effect of cognitive behavioral therapy with lamotrigine for patients with bipolar depression. Methods Subjects were randomly divided into treatment group and control group. On the basis of drug therapy for two group the treatment group was given cognitive behavioral therapy （CBT） while the control group was given general psychological support. To evaluate Hamilton depression scale （HAMD17） scores on the set of baseline and thel. 3. 5 and 8 weeks after treatment, the Coping Style Questionnaire（SCSQ） scales before and after treatment and calculate clinical total effective rate, HAMDI7 reduction rate, factors changes and SCSQ scales changes of the two groups. Results There was no significant difference between the two groups on the overall clinical efficacy and the Working time （P 〉 0. 05 ）. But cognitive behavioral therapy group had significantly better effect on the improvement of cognitive impairment and the hysteresis factor （P 〈 0. 05 ）, and can also more effectively improve the fantasy and help-seeking factor scales（ P 〈 O. 05）. Conclusions Cognitive behavior therapy（CBT） can significantly improve the coping style of patients with bipolar depression , and paying more attention to personality factors such as coping style may be an important aspect of relapse prevention for patients with bipolar depression.