中国临床心理学杂志

认知行为治疗对未服药强迫障碍患者的大样本病例研究

分类号：R395.5

出版年,卷(期):页码：2017,25(2):299-303

摘要：

目的：验证操作手册指导下的认知行为治疗（CBT）对未服药强迫障碍（OCD）患者的疗效、可接受性及适用性。方法：纳入符合DSM-IV强迫障碍诊断标准的门诊患者46例，在CBT操作手册指导下进行为期12周共14次个别CBT治疗。应用耶鲁-布朗强迫量表（Y-BOCS）、汉密尔顿抑郁量表（HAMD-17项）和汉密尔顿焦虑量表（HA-MA）进行疗效评估，并采用0-10分的视觉模拟评分法来进一步评估患者对CBT的满意度和主观有益性。研究期间不服用任何精神药物。结果：39例患者完成了14次治疗（脱落率为15.22%），对完成治疗者进行治疗前后Y-BOCS，HAMA，HAMD分值的配对t检验，结果具有显著性差异（P均小于0.01）。按照意向性治疗统计方法，有效率为69.57%（32/46），完全缓解率为21.74%（10/46），OCD患者对CBT治疗的满意度为6.89±0.42，主观有益性为6.62±0.68。结论：手册指导下的单一CBT治疗对中国OCD患者具有较好的疗效，且可接受性高，治疗依从性好。

Objective: To evaluate the efficacy of manual-based cognitive behavioral therapy(CBT) for obsessive-compulsive disorder(OCD). Methods: 46 patients who met the DSM-Ⅳ OCD criteria were recruited to receive CBT. The CBT intervention was based on a manual, including 14 sessions across 12 weeks. All participants were assessed with the YaleBrown Obsessive Compulsive Scale(Y-BOCS), Hamilton Depression Scale(HAMD) and Hamilton Anxiety Scale(HAMA) by psychiatrists not involved in the treatment. Perceived helpfulness and satisfaction with CBT were also assessed by visual analogue scale(0-10). All patients did not take any psychiatric drugs during the CBT process. Results: 39 subjects completed 14 sessions CBT. The dropout rate was 15.22%. At the end of the therapy, significant improvements were found for YBOCS, HAMD and HAMA by paired t test(P<0.01). Based on the intention to treat principle, the response and complete remission rate were 69.57%(32/46) and 21.74%(10/46). Satisfaction and helpfulness ratings were acceptable. Conclusion: The manual-based CBT is an effective and feasible therapy for drug naive OCD patients in China. The patients' compliance is good in this therapy.

基金项目：

国家自然科学基金面上项目（白质与强迫障碍：认知行为治疗的靶点与机制81271493）；国家自然科学主任基金（强迫障碍认知行为治疗的神经影像学研究81141016）

作者简介：

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