CAJ | 학술논문

目的：探讨行为激活疗法对精神分裂症后抑郁的疗效及社会功能的影响。方法将89例精神分裂症后抑郁患者随机分为研究组（45例）和对照组（44例），研究组给予行为激活疗法合并药物治疗，对照组单纯药物治疗，疗程6周，1年后随访，采用汉密尔顿抑郁量表（HAMD）、阳性和阴性综合征量表（PANSS）及社会功能缺陷筛选量表（SDSS）评定疗效。结果两组治疗后第2、4、6周末及治疗后1年HAMD评分均较治疗前下降（P＜0．05）；研究组治疗后第4、6周末及治疗后1年HAMD评分低于对照组（P＜0．01）。两组治疗后第4、6周末及治疗后1年PANSS量表阳性症状和一般病理评分及SDSS量表评分均较治疗前下降（ P＜0．05），治疗后第2、4、6周末及治疗后1年PANSS量表阴性症状和总分均较治疗前下降（ P＜0．05）；研究组治疗后第4、6周末及治疗后1年PANSS量表阴性症状和总分及SDSS量表评分均低于对照组（P＜0．05），研究组治疗后1年PANSS量表阳性症状和一般病理评分均低于对照组（P＜0．05）。研究组复发率（7％）低于对照组（25％）（P＜0．05）。结论行为激活疗法可以提高精神分裂症后抑郁患者的临床疗效，降低一年后复发率并可改善患者的社会功能。
목적：탐토행위격활요법대정신분렬증후억욱적료효급사회공능적영향。방법장89례정신분렬증후억욱환자수궤분위연구조（45례）화대조조（44례），연구조급여행위격활요법합병약물치료，대조조단순약물치료，료정6주，1년후수방，채용한밀이돈억욱량표（HAMD）、양성화음성종합정량표（PANSS）급사회공능결함사선량표（SDSS）평정료효。결과량조치료후제2、4、6주말급치료후1년HAMD평분균교치료전하강（P＜0．05）；연구조치료후제4、6주말급치료후1년HAMD평분저우대조조（P＜0．01）。량조치료후제4、6주말급치료후1년PANSS량표양성증상화일반병리평분급SDSS량표평분균교치료전하강（ P＜0．05），치료후제2、4、6주말급치료후1년PANSS량표음성증상화총분균교치료전하강（ P＜0．05）；연구조치료후제4、6주말급치료후1년PANSS량표음성증상화총분급SDSS량표평분균저우대조조（P＜0．05），연구조치료후1년PANSS량표양성증상화일반병리평분균저우대조조（P＜0．05）。연구조복발솔（7％）저우대조조（25％）（P＜0．05）。결론행위격활요법가이제고정신분렬증후억욱환자적림상료효，강저일년후복발솔병가개선환자적사회공능。
Objective To explore the influence of behavioral activation therapy on curative effect and social function in patientswithpost-schizophreniadepression.Methods 89patientswithpost-schizophreniadepressionwererandomlydivided into study group (45 cases) treated with medication combined with behavioral activation therapy for 6 weeks and control group (44 cases) only treated with medication for 6 weeks.All patients were followed up 1 year later.The efficacy was evaluated by using Hamilton Depression Scale (HAMD) and Positive and Negative Syndrome Scale (PANSS), social function was evaluated by using Social Disability Screening Schedule ( SDSS) .Results Scores of HAMD in both groups decreased significantly at the end of the 2nd, 4th, 6th week and 1 year later (P<0.05) compared with the baseline.Scores of HAMD in study group were significantly lower than those in control group at the end of the 4th, 6th week and 1 year later (P<0.01).Factor scores of positive symptom and general pathology in PANSS and total score of SDSS in both groups decreased significantly at the end of the 4th, 6th week and 1 year later when compared with the baseline (P<0.05).Total score of PANSS and factor score of negative symptom in both groups decreased significantly at the end of the 2nd, 4th, 6th week and 1 year later when compared with the baseline (P<0.05).Factor score of negative symptom and total scores of PANSS and SDSS in study group were significantly lower than those in control group at the end of the 4th, 6th week and 1 year later (P<0.05).Factor scores of positive symptom and general pathology in PANSS in study group were significantly lower than those in control group at the end of the 1-year follow-up (P<0.05).The recurrence rate in study group (7%) was significantly lower than that in control group (7%vs.25%, P<0.05).Conclusion Behavioral activation therapy can improve efficacy of medication for post-schizophrenia depression, reduce 1-year recurrence rate and improve the patient’s social function.