心理干预对难治性抑郁症患者康复治疗的影响

目的：探讨心理干预对难治性抑郁症（TRD）患者康复治疗效果的影响。方法：对2011年1月-2013年2月在我院就诊的136例（脱落7例，实际完成129例）TRD患者的临床资料行回顾性分析，根据实施心理干预与否分组，比较两组治疗前后HAMD、CGI、NOSIE、GQOLI-74等量表评分，并记录不良反应。结果：因疗程不足，观察组（原68例）脱落2例，实际完成66例；对照组（原68例）脱落5例，实际完成63例，共129例。两组患者的各指标无明显差异（P〉0．05）。与对照组相比，观察组患者在治疗8周后的HAMD和cGI减分率明显升高；NOSIE积极因子和消极因子分数明显下降；心理健康、躯体健康、物质生活、社会功能评分明显升高（P〈0．05）。两组不良反应主要以体重增加、锥体外系副反应、口干、便秘、头晕与头痛等为主，均未影响治疗。结论：对于TRD康复治疗，辅行心理干预，有助于增强药物治疗效果，改善患者预后，值得深究推广。

Effect of Psychological Intervention on the Rehabilitation of Treatment-resistant Depression

Objective： To observe the effect of psychological intervention on the rehabilitation of patients with treatment-resistant depression. Methods： The clinical materials of 136 patients （the actual completion was 129 cases, the other 7 were invalid） who were treated with treatment-resistant depression in our hospital from January 2011 to February 2013 were selected and divided into two groups, then analyzed their clinical data retrospectively and compared the score of HAMD, CGI, NOS1E, GQOLI-74, and adverse reactions between two groups. Results： 66 cases finished operation in the observation group and 63 in the control group, altogether 129 cases.. There were no statistically significant differences between two groups about the indexes of patients （P〉0.05）. After treatment for eight weeks, the reduction rates of HAMD and CGI in the observation group were increased significantly than that of the control group; the scores of positive factor and negative factor in NOSIE were significantly decreased, and the scores of mental health, physical health, material life and social function were increased significantly （P〈0.05）. The main adverse reactions were weight gained, extrapyramidal side effects, thirsty, constipation, dizzy and headache. Conclusions： For the rehabilitation of treatment-resistant depression, the use of psychological intervention could enhance the therapeutic effects, improve the prognosis of patients, and it is worthy of further promotion.