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[针对焦虑患者的综合跨诊断放松方案。一项试点研究的结果]

[An integrative and transdiagnostic relaxation protocol for anxious patients. Results of a pilot study].

作者信息

Servant D, Germe A, Autuori M, De Almeida F, Hay M, Douilliez C, Vaiva G

机构信息

Consultation spécialisée sur le stress et l'anxiété, service universitaire de psychiatrie adulte, hôpital Fontan, CHRU, rue Verhaeghe, 59037 Lille cedex, France.

Consultation spécialisée sur le stress et l'anxiété, service universitaire de psychiatrie adulte, hôpital Fontan, CHRU, rue Verhaeghe, 59037 Lille cedex, France; Unité de formation et recherche en psychologie, laboratoire Psitec, EA 4072, université Lille-3, 59650 Villeneuve-d'Ascq, France.

出版信息

Encephale. 2014 Dec;40(6):501-6. doi: 10.1016/j.encep.2014.07.001. Epub 2014 Aug 15.

Abstract

INTRODUCTION

The literature data show that relaxation practice is effective in reducing anxiety symptoms. Different techniques such as progressive muscular relaxation, autogenic training, applied relaxation and meditation have been evaluated independently for anxiety disorders. The question is to know whether the combination of various techniques may be of interest in the transdiagnostic treatment of anxiety disorders.

AIM OF THE STUDY

The present study assessed the short-term efficacy of a 10-week integrative and transdiagnostic relaxation program for anxiety disorders in outpatients of an anxiety disorders unit.

METHODS

The diagnoses were made according to the Mini-International Neuropsychiatric Interview (MINI; Sheehan et al., 1998) and completed with an assessment of anxiety and depressive symptoms using: the State Trait Anxiety Inventory (STAI-Y, -S and -T), the Penn State Worry Questionnaire (PSWQ) and the Beck Depression Inventory (BDI-II). Four techniques were integrated into the structured 10-week protocol: breathing control, muscular relaxation, meditation and mental visualization.

RESULTS

Twenty-eight patients (12 men and 16 women), mean age (S.D.)=38.82 years (11.57), were included in the study. All the included patients fulfilled the DSM-IV criteria for a current diagnosis of Generalized Anxiety Disorder (n=13) or Panic Disorder (n=15) with or without agoraphobia. At the end of the 10 sessions, we found a significant reduction in mean scores (S.D.) on the STAI-T from 53.179 (6.037) to 49.821 (8.028) (P<0.02), the BDI-II 20.964 (13.167) to 15.429 (11.341) (d=0.6543) and the QIPS 55.071 (10.677) to 49.679 (11.7) (d=0.5938). The observed reduction in the STAI-S (d=0.2776) was not significant.

DISCUSSION

The results of this open study showed that this program significantly decreases the level of trait anxiety, depression and worry. The integrative and transdiagnostic relaxation program could represent an accessible and effective treatment to reduce anxious and depressive symptoms in various anxiety disorders. Future research should address the development of controlled trials assessing the impact of the different dimensions of anxiety and the long-term effects of this protocol.

摘要

引言

文献数据表明,放松练习在减轻焦虑症状方面是有效的。诸如渐进性肌肉松弛、自生训练、应用放松和冥想等不同技巧已针对焦虑症进行了独立评估。问题在于了解各种技巧的组合对于焦虑症的跨诊断治疗是否会有意义。

研究目的

本研究评估了一项为期10周的综合跨诊断放松计划对焦虑症单元门诊患者焦虑症的短期疗效。

方法

诊断依据《迷你国际神经精神访谈》(MINI;Sheehan等人,1998年)进行,并通过使用以下量表对焦虑和抑郁症状进行评估来补充:状态特质焦虑量表(STAI-Y、-S和-T)、宾夕法尼亚州立大学忧虑问卷(PSWQ)和贝克抑郁量表(BDI-II)。四种技巧被整合到结构化的10周方案中:呼吸控制、肌肉松弛、冥想和心理想象。

结果

28名患者(12名男性和16名女性)被纳入研究,平均年龄(标准差)=38.82岁(11.57)。所有纳入的患者均符合当前诊断为广泛性焦虑症(n = 13)或惊恐障碍(n = 15)伴或不伴有广场恐惧症的DSM-IV标准。在10次疗程结束时,我们发现STAI-T的平均得分(标准差)从53.179(6.037)显著降至49.821(8.028)(P < 0.02),BDI-II从20.964(13.167)降至15.429(11.341)(d = 0.6543),QIPS从55.071(10.677)降至49.679(11.7)(d = 0.5938)。观察到的STAI-S的降低(d = 0.2776)不显著。

讨论

这项开放性研究的结果表明,该计划显著降低了特质焦虑、抑郁和忧虑水平。综合跨诊断放松计划可能是一种可行且有效的治疗方法,可减轻各种焦虑症中的焦虑和抑郁症状。未来的研究应致力于开展对照试验,评估焦虑症不同维度的影响以及该方案的长期效果。

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