团体心理治疗对焦虑症患者疗效的影响

目的探讨团体心理治疗对住院焦虑症患者的疗效及主要的疗效因素。方法将80例住院焦虑症患者随机分为两组,对照组接受常规药物治疗,试验组除接受常规药物治疗外,同时参加为期8周的团体心理治疗。比较两组患者治疗前后焦虑症症状的缓解情况,分析团体心理治疗中的疗效因素。结果①经过8周的团体心理治疗后,实验组患者的症状评分显著低于对照组。②在焦虑症团体心理治疗中重要的疗效因子依次为:希望重塑、情绪宣泄、信息传递、存在意识因子及团体凝聚力。结论团体心理治疗联合药物治疗对住院焦虑症患者的疗效更为显著。     

柳州市海洛因依赖者复吸因素调查与分析

吸毒涉及个人、家庭和社会等多方面因素,抗复吸必须有家庭和社会的参与,否则预防复吸很可能成为空话.对于普通慢性疾病患者旧病复发,我们会毫无疑问尽力救治,如以同样的心态对待戒毒者的复吸,何患无策?戒毒所里的戒毒人员除药物治疗外,还接受各种形式的毒品知识和思想教育.但家庭和社会对吸毒者的内心活动了解尚少,不利于出所后戒毒效果的持续.为了让社会了解引起戒毒者复吸的因素,了解戒毒者面对复吸的心理活动,使戒毒者得到有效的帮助,保持长期操守.我们设计一份复吸问卷调查表,于2003年6月5日以匿名方式对在所的395名吸毒人员开展调查,参与者均单独完成答卷.现将结果报告并分析如下:     

团体心理治疗对老年精神分裂症患者服药依从性的影响

目的 探讨团体心理治疗对提高老年精神分裂症患者服药依从性的效果。方法 选取2013年6月至12月收治的老年精神分裂症男性患者60例,采用随机抽签法分为治疗组和对照组各30例,所有患者均接受床位医师的药物治疗及病房的常规生活护理及康复护理。治疗组由2名心理治疗师负责团体心理治疗,对照组接受本病区护士常规生活护理及康复护理。对两组患者在治疗前、治疗6周后进行服药依从性测评。结果 治疗组服药依从性优于对照组,差异有统计学意义(P<0.05)。结论 团体心理治疗可以提高老年精神分裂症患者服药的依从性。     

药物联合认知行为疗法对精神分裂症患者自知力及社会功能恢复的对照研究

<正>近年来因"生物—心理—社会"疾病诊疗模式的提倡,精神分裂症等重性精神疾病也逐渐介入心理干预和治疗,其主要方法有社会技能训练、家庭干预、认知行为治疗(cognitive behavioral therapy,CBT)~([1])。其中,CBT是临床疗效证据较为充分的一种心理治疗方法。因此本研究选取2017年5月至2018年4月在我院住院治疗的70例精神分裂症患者作为研     

短程团体认知行为治疗个体认知行为治疗联合艾斯西酞普兰与单用艾斯西酞普兰治疗老年抑郁症120例临床疗效分析

目的研究短程团体认知行为治疗、个体认知行为治疗联合艾斯西酞普兰与单用艾斯西酞普兰治疗对于住院老年抑郁症患者的疗效,以及改善社会功能的效果。方法把符合国际精神障碍诊断和统计手册(ICD)-10抑郁症诊断标准的120例老年患者按随机数字表法,分成对照组、研究1组[短程团体认知行为治疗组(SGCBT)]和研究2组[个体认知行为治疗组(CBT)],每组40例。对照组仅使用艾斯西酞普兰,研究1组使用SGCBT联合艾斯西酞普兰,研究2组采用CBT联合艾斯西酞普兰,共观察8周,使用老年抑郁量表(GDS)以及汉密尔顿抑郁量表(HAMD)进行疗效比较。结果8周后,3组的治疗均有效,其中研究1、2组与对照组的HAMD和GDS评分均有显著下降,差异具有统计学意义(P<0.01);SGCBT组在第2周较CBT组HAMD的减分较低,第3~8周差异有统计学意义(P<0.01)。结论对老年住院抑郁症患者,认知行为治疗联合药物治疗方法较单纯的药物治疗效果更佳,其中SGCBT比CBT起效更快,疗效更好。     

团体认知行为心理治疗在慢性疼痛患者中的应用研究

目的评价团体认知行为疗法治疗慢性疼痛患者的疗效。方法对23例团体CBT治疗组患者实行疼痛科常规住院治疗联合团体CBT治疗,对照组仅采取疼痛科常规住院治疗;全部患者在治疗前和出院时进行90项症状清单（SCL-90）及简明疼痛量表（BPI）评分。结果团体CBT治疗组SCL-90躯体化、抑郁、焦虑、精神病性及其他项目分值治疗前后存在显著降低（P〈0.01）,强迫分值下降（P〈0.05）,对照组治疗前后躯体化分值显著下降（P〈0.01）,抑郁及其他项目分值降低（P〈0.05）;治疗组BPI疼痛强度因子减分差值更大,但与对照组相比无统计学差异（P〉0.05）;干扰日常生活因子减分两组存在显著差异,治疗组比对照组更为有效（P〈0.01）。结论团体认知行为心理治疗可改善腹性疼痛患者的精神状态以及对疼痛的适应能力,值得临床推广。     

团体心理治疗对住院神经症患者的影响

目的 对住院神经症患者接受团体心理治疗的疗效进行探讨。方法 选取我院2011年2月至2014年2月收治的住院神经症患者共100例,将其随机分为对照组和观察组。对对照组患者进行常规治疗,对观察组患者在常规治疗的基础上进行支持性团体心理治疗,治疗时间为8周。对两组患者的神经症症状改善效果进行比较。结果 观察组患者在人际关系敏感、强迫症状、躯体不适、抑郁、焦虑等评分都低于对照组,差异具有统计学意义(P<0.05)。结论 对住院神经症患者进行团体心理治疗有着良好的疗效。     

曲唑酮联合心理治疗对海洛因依赖者脱毒期的疗效观察

目的:观察曲唑酮联合心理治疗对海洛因依赖者脱毒期间的临床疗效,探讨其在改善成瘾者心理状况、防复吸等方面的作用.方法:120例接受丁丙诺非维持治疗(BMT)的海洛因依赖者随机分为对照组、曲唑酮组、心理治疗组、曲唑酮+心理治疗组,每组30例.治疗前后,采用稽延性症状评定量表、汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、海洛因渴求评定量表、自我控制量表分别对患者进行问卷调查.结果:曲唑酮和心理治疗均能改善海洛因依赖者脱毒期间的焦虑、抑郁症状;与曲唑酮组、心理治疗组比较,曲唑酮联合心理治疗在改善焦虑、抑郁症状方面疗效更显著.心理治疗还可降低渴求、增加自我控制能力,而曲唑酮在降低渴求、增加自我控制能力方面则无明显疗效.结论:曲唑酮联合心理治疗可有效控制海洛因依赖者脱毒期间焦虑、抑郁症状,并能增加海洛因依赖者自我控制能力,降低渴求,对预防复吸具有积极作用.     

注射用纳曲酮微球预防阿片类药物依赖复吸的临床研究

目的：评估注射纳曲酮微球预防阿片类药物依赖复吸的疗效和安全性。方法：筛选符合海洛因依赖且无其他躯体疾病,年龄18~45岁,至少有3次复吸史,自愿接受戒毒治疗的患者24例。随机纳入研究组及对照组,研究组注射纳曲酮微球,对照组服用盐酸纳曲酮片;疗程均为20周,停药后随访4周。在第0、2、4、8、12、16、20、24周时观察疗效和安全性。结果：研究组和对照组各纳入12名海洛因依赖患者,1名患者未参加随访,2名患者中途退出,共有21名患者（研究组11人,对照组10人）顺利完成实验。自给药后4~24周,研究组尿检阴性率均高于对照组,其差异在接受治疗后8周时有统计学意义（P =0.035）。研究组5人（45.5%）及对照组中2人（20.0%）完成全部访视。研究组与对照组的平均脱落时间分别为18.55周与11.40周,差异有统计学意义（P=0.033）。自用药后4周,研究组用药1 h后渴求评分均低于对照组,在访视5（用药后4周）和访视7（用药后12周）时有显著性差异（P=0.028;P=0.042）。在整个研究过程中,没有出现严重的治疗相关不良事件。结论：与口服纳曲酮片相比,注射用纳曲酮微球能降低患者复吸风险,减轻患者戒毒期间对毒品的渴求程度,提高患者服药依从性,增加其自愿接受治疗的时间,无不良事件发生风险,可以考虑作为海洛因依赖防复吸治疗的有效手段。     

团体和家庭心理治疗对抑郁障碍患者家庭亲密度与适应性的影响

<正>目前,对于团体心理治疗对抑郁障碍患者家庭亲密度与适应性的影响方面的报道比较少见,本研究选取团体心理治疗加药物治疗组,家庭心理治疗加药物治疗组和单独药物治疗组各30例为研究对象,通过研究在系统团体心理治疗中     

Acquisition and retention of skills training methods in chronic schizophrenic outpatients.

Forty-one DSM-III-R schizophrenic subjects on constant, low-dose maintenance neuroleptic drug therapy (5-10 mg of fluphenazine decanoate intramuscularly every 2 weeks) were randomly assigned to structured and modularized skills training or to supportive group psychotherapy. The skills training was designed by using cognitive and behavioral methods to compensate for the learning disabilities that plague many schizophrenic patients. Skill acquisition was assessed by using quantified performance on standardized role-play tests. Subjects who received skills training made significant gains in each of the areas taught, whereas those who participated in the control psychotherapy group did not. The knowledge and skills learned during training were retained without significant erosion over a 1-year followup period. These results suggest that the use of structured principles of learning and cognitive therapy can effectively train schizophrenics in skill areas pertinent to the self-management of their illness.     

心理干预对海洛因依赖者的康复效果

目的:探讨心理干预对海洛因依赖者的康复效果。方法:按抛硬币分组法将120例海洛因依赖者分为研究组和对照组,各60例,两组均按常规药物治疗和护理,对照组参加日常的军事训练、学习、劳动卫生、体育锻炼等工疗活动,研究组在此基础上进行为期8周以健康教育、音乐治疗和书画训练为主要内容的心理干预。采用抑郁自评量表(SAS)、焦虑自评量表(SDS)和症状自评定量表(SCL-90)进行效果评定,并且分别于出院后2周、4周和8周后进行随访和尿检,评价复吸情况。结果:干预前,SAS、SDS和SCL-90等量表的评分,两组间比较差异无显著性(均P>0.05)。干预后,SAS、SDS和SCL-90等量表的评分,研究组均明显低于对照组(P<0.05或P<0.01)。复吸率比较,研究组明显好于对照组(P<0.05或P<0.01)。结论:心理干预能够改善海洛因依赖者的不良情绪和心理障碍,提高其心理健康水平,对预防复吸和保持操守有一定的促进作用。     

The design and evaluation of a simulated‐patient teaching programme to develop the consultation skills of undergraduate pharmacy students

Objectives: This study aimed to identify the key skills and knowledge required for the delivery of an ideal patient consultation in order to develop a training programme (using simulated-patients) to teach consultation skills to undergraduate pharmacy students. Methods:Participants included all third year undergraduate Pharmacy students (MPharm, level III) at the School of Pharmacy & Biomolecular Sciences, University of Brighton (from October 1999 to March 2000). Working in groups of 12, students participated in two 4 hour seminars. A structured questionnaire was designed to assess students' perceptions of the difficulty of conducting a consultation and their confidence in delivering a structured consultation. Main outcome measures: Questionnaires were administered before and after delivery of the teaching programme to assess changes in students' confidence and ability to consult with patients.Results:Twelve volunteers satisfied the criteria set to serve as simulated patients and then received appropriate training. Six scenarios were developed which focused on the key skills and knowledge identified from the adherence and consultation skills literature. A total of 91 students participated in the programme (mean age=23 years, SD=4.5). Following participation in the programme students' perceived 'confidence' for conducting an effective consultation significantly increased (t=-5.9,p<0.01) while a statistically significant decrease was seen in students' perceived level of 'difficulty' when conducting a consultation (t=4.0, p<0.01).Conclusion: This study has shown that the use of a structured teaching programme improves students' perceptions of their ability and confidence in conducting an effective consultation. Providing skills training around the consultation process, using simulated patients, provides pharmacists with a good framework around which to practice pharmaceutical care.     

Group cognitive-behavioral therapy for women with PTSD and substance use disorder

This paper describes a model of group cognitive-behavioral therapy (CBT) for women with posttraumatic stress disorder (PTSD) and substance use disorder (SUD). The need for specialized treatment derives from the high incidence of these comorbid disorders among women as well as from their particular clinical presentation and treatment needs. The treatment educates patients about the two disorders, promotes self-control skills to manage overwhelming affects, teaches functional behaviors that may have deteriorated as a result of the disorders, and provides relapse prevention training. The program draws on educational principles to make it accessible for this population: visual aids, education for the patient role, teaching for generalization, emphasis on structured treatment, testing of acquired knowledge of CBT, affectively engaging themes and materials, and memory enhancement devices.     

音乐心理剧对海洛因依赖者戒毒动机的干预

目的:研究音乐心理剧对我国海洛因依赖者的戒毒动机和操守的临床干预效果。方法:将62名女性海洛因依赖者随机分为实验组(n=31)和对照组(n=31)。实验组进行为期12周的Joseph.J.Moreno音乐心理剧临床干预;对照组常规治疗。将实验组干预后的戒毒动机与干预前及对照组进行比较;追踪所有被试的复吸情况并进行统计;对总体戒毒动机、操守率和各戒毒动机因子进行相关分析,了解干预的方法对戒毒动机和操守率的干预效果。结果:实验组总体戒毒动机与对照组和干预前相比显著提高(P<0.05);总体戒毒动机与"家庭因子"呈显著正性相关(r=0.364)。实验组操守情况(58.06%,18/31)优于对照组(35.48%,11/31),但无统计学意义上的显著性差异(P>0.05)。结论:音乐心理剧临床干预对提高海洛因依赖人群的戒毒动机有明显作用,但在提高复吸率方面效果不明显。提高戒毒动机需要从家庭角度进行干预。由于文化上的差异,本法在临床运用的过程中有些技术的使用存在一定的局限性。     

Naltrexone plus group therapy for the treatment of opiate-abusing health-care professionals

Purpose: The success rate of a treatment program tailored to opioid-abuing health-care professionals that included oral naltrexone and group therapy was studied. Methods: 20 opioid-abusing health professionals were treated over a 5-year-period. Clients received an initial assessment, supervised administration of naltrexone, and weekly attendance at a psychotherapy group for health professionals. Naltrexone was administered for the first several months, then patients continued the program without naltrexone. Results: 18 patients were referred to the program after being caught diverting medication. Two patients came spontaneously. Of the 18 referred patients, 12 had no relapses, and 5 had only one relapse, followed by long-term sobriety. Mean overall duration of naltrexone administration was 8 months, and the mean duration in the program was 1.9 years. 94% of referred clients had long term abstinence, and 66% were working in their profession during the program. Conclusions: Naltrexone in the setting of a structured program is helpful in the treatment and professional reinstatement of opioid abusing health professionals.     

Treating crack cocaine dependence: the critical role of relapse prevention

In order to adequately address the treatment needs of crack cocaine dependent persons, a multidimensional approach to relapse prevention must be utilized. The value of a biopsychosocial model of crack addiction and the concept of phases of recovery in providing a rationale for the recommended approach to relapse prevention are emphasized. Research findings on the determinants of relapse for crack dependent patients and the psychosocial characteristics of the crack dependent individual justify the utility of certain relapse prevention strategies. Specifically, an approach to relapse is advocated that includes the provision of pharmacological adjuncts, psychoeducation on the multideterminants of relapse, and psychotherapy that attempts to remediate underlying psychological problems that are typically found in crack dependent patients.     

Treating crack cocaine dependence: the critical role of relapse prevention.

In order to adequately address the treatment needs of crack cocaine dependent persons, a multidimensional approach to relapse prevention must be utilized. The value of a biopsychosocial model of crack addiction and the concept of phases of recovery in providing a rationale for the recommended approach to relapse prevention are emphasized. Research findings on the determinants of relapse for crack dependent patients and the psychosocial characteristics of the crack dependent individual justify the utility of certain relapse prevention strategies. Specifically, an approach to relapse is advocated that includes the provision of pharmacological adjuncts, psychoeducation on the multideterminants of relapse, and psychotherapy that attempts to remediate underlying psychological problems that are typically found in crack dependent patients.     

Naltrexone and relapse prevention treatment for cocaine-dependent patients

A double-blind, placebo-controlled clinical trial examining the joint action of naltrexone (NTX) in combination with relapse prevention (RP) therapy for the treatment of cocaine dependence was conducted. Eighty-five participants who achieved initial abstinence during the intake evaluation and detoxification phase of the study were randomized into 1 of 4 combined NTX (0 vs. 50 mg) by therapy (RP vs. Drug Counseling) experimental conditions for the 12-week outpatient treatment phase of the study. A random effects regression model to test for group differences on percentage of cocaine-positive urines indicated a significant time by medication by therapy interaction, suggesting less cocaine use over time among subjects receiving RP-50 mg than those in the other conditions. No differences were found for retention or time until first cocaine-positive urine. Naltrexone was well tolerated by participants, with acceptable rates of medication compliance observed. Treatment integrity measures confirmed successful manipulation of the psychotherapy. These results are consistent with the notion that substance use in dependent patients can be reduced with a combination of coping skills training and pharmacologic treatments.