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躯体化患者接受个体认知行为疗法与团体认知行为疗法后健康相关生活质量的变化:一项随机临床试验。

Health related quality of life changes in somatising patients after individual versus group cognitive behavioural therapy: a randomized clinical trial.

机构信息

Institut Universitari d´Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Ctra Valldemossa km 7,5, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RedIAPP), Avda Gran Via de les Corts Catalanes, 587 Ático, Barcelona, Spain.

Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RedIAPP), Avda Gran Via de les Corts Catalanes, 587 Ático, Barcelona, Spain; Arrabal Health Center, Department of Family Medicine, C/Andador Aragües del Puerto, 2-4, Zaragoza, Spain.

出版信息

J Psychosom Res. 2014 Feb;76(2):89-93. doi: 10.1016/j.jpsychores.2013.10.018. Epub 2013 Nov 6.

Abstract

OBJECTIVE

To assess changes in health related quality of life after a cognitive behavioural program for patients diagnosed with abridged somatization disorder in primary care.

METHOD

A multicentre, randomized, parallel group, controlled trial was designed. 168 patients were recruited from 29 primary health care centres in Spain and were randomly assigned to one of the three study arms: treatment as usual improved with Smith's norms, individual cognitive behavioural treatment, and group cognitive behavioural treatment. Health-related quality of life was assessed using SF-36 Health Survey.

RESULTS

Individual cognitive behavioural treatment achieves greater changes in health related quality of life than group cognitive behavioural therapy and treatment as usual. Improvement in health related quality of life was fully observed at 12 month, and partially at 6 months. The modality of intervention interacts with time in all dimensions except for Physical functioning and Vitality. Patients who received individual cognitive behavioural therapy treatment had better scores in Physical and Mental health summary measures at 12 month follow-up.

CONCLUSIONS

Individual cognitive behavioural treatment is the most effective way to improve health related quality of life in abridged somatization disorder patients, and its effects are sustained over time. Also, regardless of the type of intervention, physical functioning improves compared with treatment as usual.

摘要

目的

评估认知行为方案对初级保健中缩短躯体化障碍患者的健康相关生活质量的变化。

方法

设计了一项多中心、随机、平行组、对照试验。从西班牙 29 个初级保健中心招募了 168 名患者,并将其随机分配到三个研究组之一:常规治疗+ Smith 标准、个体认知行为治疗和小组认知行为治疗。使用 SF-36 健康调查评估健康相关生活质量。

结果

个体认知行为治疗比小组认知行为治疗和常规治疗更能改变健康相关的生活质量。在 12 个月时完全观察到健康相关生活质量的改善,在 6 个月时部分观察到改善。干预模式与所有维度(除身体功能和活力外)的时间都存在交互作用。在 12 个月的随访中,接受个体认知行为治疗的患者在身体和心理健康综合测量方面的评分更好。

结论

个体认知行为治疗是改善缩短躯体化障碍患者健康相关生活质量的最有效方法,其效果随着时间的推移而持续。此外,无论干预类型如何,与常规治疗相比,身体功能都有所改善。

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