认知行为疗法联合药物治疗对轻性抑郁障碍的临床对照研究

目的比较认知行为疗法、帕罗西汀治疗及两者联合治疗对轻性抑郁障碍患者的临床疗效及预后。方法将96例轻性抑郁障碍患者分为认知行为治疗组、药物治疗组及联合治疗组,治疗6周,利用汉密顿抑郁量表（HAM D）分别在治疗前、治疗2、4、6周末评定减分值及疗效,6个月时评定再燃率。结果①治疗第2周末3组HAM D减分值差异无统计学意义（F=4.07,P=0.052）;治疗第4周末3组HAM D减分值差异有统计学意义（F=3.40,P=0.036）;治疗第6周末联合治疗组减分值高于其它两组,但3组HAM D减分值差异无统计学意义（F=4.58,P=0.061）;②3组第6周末疗效差异有统计学意义（U=75.6,P=0.04）;③6个月随访3组再燃率有统计学意义（U=112.6,P=0.041）。结论认知行为治疗联合药物治疗是轻性抑郁障碍的最佳治疗方法。

Comparative Study of Cognitive-behavior Therapy Combined with Pharmacotherapy in Treatment of Minor Depression.

Objective To compare the clinical efficacy and prognosis of cognitive-behavior therapy（CBT）,Paroxetine and Combination therapy in the treatment of minor depression.Methods Ninety-six patients with minor depression were divided into CBT,Paroxetine and combination groups with 32 patients respectively,and were treated for six weeks.The Hamilton Depression Scale（HAMD） was used to evaluate the clinical efficacy of the three groups.Results ①At the end of 2 weeks,there was not significant difference in the reduction of the HAMD score among the three groups（F=4.07,P=0.052）.②Significant difference was found in scores among the three groups（F=3.40,P=0.036） at the end of 4 weeks.The rate of score reduction in the combination group was higher than that of the other two groups.③There was significant difference in the efficacy（U=75.6,P=0.04）and recrudescence（U=112.6,P=0.041）among the three groups.Conclusion It is the best way in treatment of minor depression that cognitive-behavior therapy combinated with antidepressant.