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挪威的强迫症行为团体治疗。一项开放性基于社区的试验。

Behavioural group therapy for obsessive-compulsive disorder in Norway. An open community-based trial.

机构信息

Clinic of Mental Health, Psychiatry and Addiction Treatment, Sørlandet Hospital HF, Kristiansand, Norway.

出版信息

Behav Res Ther. 2010 Jun;48(6):547-54. doi: 10.1016/j.brat.2010.03.005. Epub 2010 Mar 12.

Abstract

The aim of the current study was to test the effectiveness of ERP-based 12 weeks group therapy for OCD patients in a community-based, general Norwegian outpatient clinic. The sample consisted of 54 patients diagnosed with OCD. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory (BDI) and the Spielberger State Anxiety Inventory (STAI-S) were administered before treatment, after treatment and at 3- and 12-month follow-ups. Analyses with mixed models for repeated measurements showed that group behavioural therapy offered to OCD patients significantly improved ratings of obsessive-compulsive symptoms, depression and anxiety. These improvements were maintained at 3- and 12-month follow-ups and an additional reduction in obsessive-compulsive symptoms was observed from post-treatment to 3-month follow-up. However, the delayed effect of therapy was no longer present at 12-month follow-up. The results also revealed that the patients had a lower chance for an increased outcome category (e.g. from unchanged to improved or recovered) with high scores on STAI-S at the given observation times (post-treatment, 3- and 12-months follow-ups). Depressive symptoms (BDI) at post-treatment and follow-ups had no significant influences on the three categories of outcome for OCD. In conclusion, the results indicate that behavioural group therapy can successfully be delivered to patients with considerable comorbidity in a real world setting conducted by therapists with limited training in the CBT.

摘要

本研究旨在检验基于 ERP 的 12 周团体治疗对挪威社区普通门诊中强迫症患者的疗效。该样本包括 54 名被诊断为强迫症的患者。在治疗前、治疗后以及 3 个月和 12 个月随访时,采用耶鲁-布朗强迫量表(Y-BOCS)、贝克抑郁量表(BDI)和斯皮尔伯格状态焦虑量表(STAI-S)进行评估。采用重复测量混合模型分析显示,为强迫症患者提供的团体行为治疗显著改善了强迫症状、抑郁和焦虑的评分。这些改善在 3 个月和 12 个月的随访中得以维持,并且从治疗后到 3 个月的随访中观察到了强迫症状的进一步减少。然而,在 12 个月的随访中,治疗的延迟效应不再存在。研究结果还表明,在给定的观察时间点(治疗后、3 个月和 12 个月随访),STAI-S 得分较高的患者,其治疗效果的改善程度(例如从不改善到改善或痊愈)的可能性较低。治疗后和随访时的抑郁症状(BDI)对强迫症的三个结局类别没有显著影响。总之,研究结果表明,在治疗师接受有限认知行为治疗培训的现实环境中,行为团体治疗可以成功地应用于存在严重共病的患者。

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