【摘要】：目的 研究重癥抑郁障礙患者在達(dá)到臨床痊愈標(biāo)準(zhǔn)后心理社會(huì)功能的特點(diǎn),并進(jìn)一步分析影響其心理社會(huì)功能恢復(fù)水平的因素,以初步探索促進(jìn)重癥抑郁障礙患者全面康復(fù)的治療方案。方法 采用自編信息調(diào)查問(wèn)卷、生活質(zhì)量綜合評(píng)定問(wèn)卷(GQOLI-74)的軀體、心理、社會(huì)功能分量表、24項(xiàng)漢密頓抑郁量表(HAMD-24)、Beck抑郁問(wèn)卷(BDI)、自動(dòng)思維問(wèn)卷(ATQ)、特征應(yīng)對(duì)方式問(wèn)卷(TCSQ)、社會(huì)支持評(píng)定量表(SSS)、生活事件量表(LES),使用獨(dú)立樣本非參檢驗(yàn)、獨(dú)立樣本t檢驗(yàn)和多元線性回歸分析的統(tǒng)計(jì)處理方法,對(duì)40例經(jīng)常規(guī)住院治療后達(dá)到臨床痊愈的重癥抑郁障礙患者和40例正常人進(jìn)行調(diào)查分析。 結(jié)果 1.研究組和對(duì)照組心理社會(huì)功能的比較 (1)研究組軀體功能維度得分顯著低于對(duì)照組(t=-2.16,P0.05),其中軀體不適感因子得分(t=-3.00,P0.01)和進(jìn)食功能得分(t=-2.66,P0.01)均顯著低于對(duì)照組； (2)研究組心理功能維度中的精神緊張度因子得分顯著低于對(duì)照組(t=-2.04,P0.05); (3)研究組社會(huì)功能維度中的工作與學(xué)習(xí)因子(t=-3.73,P0.01)和婚姻與家庭因子得分(t=-4.14,P0.01)均顯著低于對(duì)照組,業(yè)余娛樂(lè)生活因子得分顯著高于對(duì)照組(t=2.66,P0.05)。 2.研究組軀體功能的多元線性回歸分析 (1)自動(dòng)思維(t=-3.82,P0.01)和客觀社會(huì)支持水平(t=2.44,P0.05)是研究組軀體功能維度的顯著影響因素； (2)消極應(yīng)對(duì)方式是其軀體不適感因子的顯著影響因素(t=2.56,P0.05)； (3)自動(dòng)思維是其進(jìn)食功能的顯著影響因素(t=-3.73,P0.01)。 3.研究組心理功能的多元線性回歸分析對(duì)抑郁癥狀的自我評(píng)估(t=-3.77,P0.01)和主觀社會(huì)支持水平(t=2.06, P0.05)是研究組心理功能中精神緊張度因子的顯著影響因素。 4.研究組社會(huì)功能的多元線性回歸分析 (1)負(fù)性生活事件(t=-4.83,P0.01)和應(yīng)對(duì)方式(t積=-2.00,P積0.05；t消=2.53,P消0.01)是研究組社會(huì)功能中工作與學(xué)習(xí)因子的顯著影響因素； (2)對(duì)抑郁癥狀的自我評(píng)估(t=-4.41,P0.01)和社會(huì)支持水平(t主=3.37,P主0.01；t客=-2.32,P客0.05)是其婚姻與家庭因子的顯著影響因素； (3)消極應(yīng)對(duì)方式(t=2.11,P0.05)和客觀社會(huì)支持(t=3.2,P0.01)是其業(yè)余娛樂(lè)生活因子的顯著影響因素。 結(jié)論 臨床痊愈后重癥抑郁障礙患者的心理社會(huì)功能恢復(fù)遲滯于癥狀恢復(fù),主要表現(xiàn)在軀體不適感、進(jìn)食障礙、精神緊張度、工作與學(xué)習(xí)功能和婚姻與家庭功能幾方面,不過(guò)此時(shí)患者的業(yè)余娛樂(lè)生活質(zhì)量較高�；颊邔�(duì)癥狀的自我評(píng)估、自動(dòng)思維方式、應(yīng)對(duì)方式、社會(huì)支持水平和負(fù)性生活事件可能是影響患者心理社會(huì)功能恢復(fù)的幾個(gè)重要因素。
[Abstract]:Objective to study the characteristics of psycho-social function in patients with severe depressive disorder after meeting the clinical recovery standard, and to analyze the factors affecting the level of psycho-social function recovery. To explore the treatment scheme to promote the comprehensive rehabilitation of patients with severe depressive disorder. Methods A self-designed information questionnaire and a comprehensive quality of life (GQOLI-74) questionnaire were used to assess the physical, psychological and social functions of the questionnaire, and 24 items of HAMD-24), Beck Depression scale (BDI),) were used. Automatic thinking questionnaire (ATQ), characteristic coping style questionnaire (TCSQ), Social support rating scale (SSS), Life events scale (LES), used independent sample non-reference test. Independent sample t-test and multivariate linear regression analysis were used to investigate and analyze 40 patients with severe depressive disorder and 40 normal controls. Result 1. Comparison of psychosocial function between study group and control group (1) the score of somatic function dimension in study group was significantly lower than that in control group (t = 2.16, P 0.05), in which the score of somatic discomfort factor was significantly lower than that of control group (t = 3.00, P < 0.05). The scores of P0.01) and eating function (tF- 2.66, P0.01) were significantly lower than those in the control group. (2) the scores of mental stress factor in the mental function dimension of the study group were significantly lower than those in the control group (t = 2.04, P 0.05); (3) the scores of work and learning factors (tr) and marriage and family factors in the social function dimension of the study group were significantly lower than those in the control group. The score of leisure life factor was significantly higher than that of control group (t = 2.66 P 0.05). 2. Multiple linear regression analysis of somatic function in the study group (1) automatic thinking (tr-3.82 P0.01) and objective social support (t 2. 44 P 0. 05) were significant influencing factors of somatic function in the study group. (2) negative coping style was a significant factor of somatic discomfort (T2.56P 0.05); (3). Automatic thinking was a significant influence factor of eating function (TG-3.73 P0.01). 3. Multiple linear regression analysis of the psychological function of the study group was used to evaluate the depression symptoms (t = -3.77, P 0.01) and the level of subjective social support (t = 2.06, P < 0.05). P05) is a significant factor of mental stress in the psychological function of the study group. 4. Multivariate linear regression analysis of social function in the study group (1) negative life events (t = -4.83) and coping styles (t product = -2.00 P product 0.05); T elimination = 2.53% P cancellation 0.01) is a significant influence factor of work and learning in the social function of the study group. (2) Self-assessment of depressive symptoms (tng-4.41, P0.01) and social support level (t = 3.37, P < 0.01); T = -2.32 P (0.05) is a significant factor affecting marriage and family. (3) the negative coping style (t0. 11 P 0.05) and objective social support (t 2. 2 0. 01) were the significant influencing factors of the leisure life factors. Conclusion the recovery of psycho-social function of patients with severe depressive disorder after clinical recovery is delayed by symptom recovery, which is mainly manifested in somatic discomfort, eating disorder, mental stress, work and learning function, marriage and family function. But at this time the patient's amateur entertainment life quality is higher. Patients' self-assessment of symptoms, automatic thinking, coping style, social support level and negative life events may be important factors affecting the recovery of patients' psychosocial function.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R749.4

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