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功能性消化不良的心理治疗

Psychotherapy in functional dyspepsia.

作者信息

Haug T T, Wilhelmsen I, Svebak S, Berstad A, Ursin H

机构信息

Department of Psychiatry, Haukeland University Hospital, University of Bergen, Norway.

出版信息

J Psychosom Res. 1994 Oct;38(7):735-44. doi: 10.1016/0022-3999(94)90026-4.

Abstract

Patients with functional dyspepsia were assigned at random to cognitive psychotherapy (10 sessions of 50 min duration, n = 50) or to a control group (no treatment, n = 50). Before treatment all patients were assessed on psychological, somatic and lifestyle factors. If allocated to the therapy group all patients were also asked to define the main problems they wanted to discuss in therapy ('target complaints'). The patients were evaluated at the end of therapy (after 4 months) and at 1 yr follow-up. Outcome measures were dyspeptic symptoms, scores on 'target complaints' and psychological parameters. Both groups showed improvement in dyspeptic and psychological parameters after 1 yr. The improvement in the control group was attributed to a non- specific effect of increased interest and attention. The therapy group showed greater reduction than the control group on dyspeptic symptoms [days of epigastric pain (p = 0.050), nausea (p = 0.024), heartburn (p = 0.021), diarrhoea (p = 0.002) and constipation (p = 0.047)]; and on scores on 'target complaints' (p = 0.001).

摘要

功能性消化不良患者被随机分为认知心理治疗组(10次,每次50分钟,n = 50)或对照组(不治疗,n = 50)。治疗前,对所有患者进行心理、躯体和生活方式因素评估。若被分配到治疗组,所有患者还需确定他们想在治疗中讨论的主要问题(“目标主诉”)。在治疗结束时(4个月后)及1年随访时对患者进行评估。疗效指标为消化不良症状、“目标主诉”得分和心理参数。两组在1年后消化不良和心理参数均有改善。对照组的改善归因于兴趣和关注度增加的非特异性效应。治疗组在消化不良症状[上腹部疼痛天数(p = 0.050)、恶心(p = 0.024)、烧心(p = 0.021)、腹泻(p = 0.002)和便秘(p = 0.047)]及“目标主诉”得分(p = 0.001)方面的降低幅度大于对照组。

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