影响阅读疗法对抑郁症疗效的多因素分析

目的探讨影响阅读疗法对抑郁症疗效的多因素。方法共103例抑郁症患者接受阅读疗法的干预,用24项汉密顿抑郁量表对其进行疗效评定,疗效好者为干预有效组,疗效差者为干预无效组,并分析影响阅读疗法对抑郁症疗效的有关因素。结果共103例抑郁症患者中,阅读疗法效果好者占74.76%,效果差者占25.24%;经单因素分析,两组在性别、受教育程度、抑郁症家族史、抑郁症发作次数、是否伴慢性躯体疾病、起病形式、治疗依从性、应对方式问卷的解决问题因子分、自责因子分、求助因子分、社会支持评定量表的主观支持因子分、客观支持因子分和支持利用度因子分等方面存在显著性差异（P〈0.05）;经多元逐步回归分析,影响阅读疗法疗效的主要因素依次为治疗依从性好（r=-0.61）、受教育程度高（r=-0.29）、SSRS支持利用度因子分高（r=3.72）、CMI求助因子分高（r=0.23）、不伴慢性躯体疾病（r=0.21）。结论阅读疗法对抑郁症的疗效受患者生理、心理、社会等多方面因素的影响。

A multiple factors analysis on efficacy of bibliotherapy for patients with depression in rehabilitation

Objective To explore influencing factors on efficacy of bibliotherapy for patients with depression in rehabilitation. Methods A total of 103 patients with depression in rehabilitation received bibliotherapy were evaluated with the Hamilton Depression Scale （HAMD）, Coping Methods Inventory （CMI） and Social Support Rating Scale （SSRS）. According results of HAMD, all patients were divided into efficacy group or inefficacy group. The related factors which affected efficacy were analyzed. Results There were 77 patients with good curative effect in efficacy group and 26 patients with poor curative effect in inefficacy group. Between two groups, there were significant differences in sex, education, family history, recurrent, with somatic disorders, onset, compliance, solving problems, recourse, remorse factors scores in CMI, objective support, subjective support and using-support degree factors in SSRS. Stepwise regression analysis showed that the main factors that influenced the efficacy of bibliotherapy were high compliance（r=-0.61）, high education（r=-0.29）, high recourse factor scores in CMI（r=0.23）, high using-support degree factor scores in SSRS（r=3.72）, without somatic disorders（r=0.21）. Conclusion The efficacy of bibliotherapy for patients with depression in rehabilitation is associated with bio-psycho-social factors.