早期心理干预对卒中后抑郁患者心理特征的影响

摘要

目的:探讨早期心理干预对卒中后抑郁患者心理特征的影响.方法:将135例急性脑梗死患者随机分为常规治疗组(n=68)及心理干预组(n=67),分别观察急性脑梗死后第7天和第21天卒中后抑郁发病率情况,采用抑郁自评量表及汉密顿抑郁量表进行抑郁状态评价,采用症状自评量表(SCL-90)评估卒中后抑郁患者心理特征.结果:急性脑梗死卒中后抑郁发病率为38.5％,其中常规治疗组卒中后抑郁发病率(54.4％)显著高于心理干预组(22.4％)(X2=14.6143,P＜0.01)；急性脑梗死发病第7天及第21天,心理干预组卒中后抑郁患者SDS评分均较常规治疗组降低(t=2.07,P＜0.05；t=6.70,P＜0.01)；在急性脑梗死发病第7天,心理干预组PSD患者HAMD评分与常规治疗组比较无显著差异(t=1.91,P＞0.05),而在第21天,心理干预组PSD患者HAMD评分显著低于常规治疗组(t=1.91,P＜0.05)；心理干预组患者SCL-90评分较常规治疗组患者显著降低.结论:早期心理干预能有效降低急性脑梗死患者卒中后抑郁的发生,并能有效改善卒中后患者的心理障碍.%Objective: To investigate the effect of psychological intervention on the mental feature of patients with post-stroke depression (PSD). Method: 135 cases with acute cerebral infarct were randomly divided into conventional therapy group (n = 68) and psychological intervention group (n = 67). The morbidity of PSD were assessed, and self-depression scale (SDS) and Hamilton Depression Scale (HAMD) were measured at 7th day and 21th day after admission. Self-reporting Inventory (SCL-90) was used to evaluate the psycholoigcal features in patients with PSD. Result:The total morbidity of PSD with acute cerebral infarct was 38.5%. Among them,the morbidity of conventional therapy group (54.4% ) was significantly lower than that of the psychological intervention group (22.4% ) ( X2 = 14. 6143, P<0. 01). The score of SDS in conventional therapy group was significantly lower than that of the psychological intervention group at 7th days and 21th days after admission(t = 2.07,P<0. 05 ;t = 6. 70, P<0.01). However,the score of HAMD in conventional therapy group was no significant difference in contrast to the psychological intervention group at 7th days after admission, and the score of HAMD in conventional therapy group was significantly lower in contrast to the psychological intervention group at 21th day after admission (t= 1.91 ,P<0.05). The score of SCL-90 in the psychological intervention group was decreased significantly than that in the conventional therapy group. Conclusion: The early psychological intervention could decreased the morbidity of PSD in patients with acute infarct.and improved the psychological disorders in patients with PSD.