Craig A R, Hancock K, Dickson H, Chang E
Department of Health Science, University of Technology, Sydney, NSW, Australia.
Arch Phys Med Rehabil. 1997 Jan;78(1):33-8. doi: 10.1016/s0003-9993(97)90006-x.
Although there are many anecdotal reports that psychological intervention is effective in enhancing adjustment to spinal cord injury (SCI), there are little data to support this assertion. To date, reports of few longitudinal-based controlled trials that assessed psychological outcomes for SCI persons have been published. This study was conducted to determine long-term efficacy of cognitive behavior therapy during rehabilitation.
The study employed a nonrandomized controlled trial, and measures were taken on three occasions: before, immediately after, and 12 months after treatment. SETTING, OUTCOME MEASURES, AND INTERVENTION: Anxiety, depressive mood, and self-esteem were assessed in 28 SCI persons consecutively selected on admission to hospital, who participated in specialized group cognitive behavior therapy (CBT) during rehabilitation.
The intervention group's responses on the measures were compared with a control group of 41 SCI persons who only received traditional rehabilitation services during their hospitalization.
There were no overall group differences on anxiety, depressive mood, and self-esteem, although there was a trend for the treatment group to have greater levels of improvement in depression scores across time in comparison to the control group. However, those in the treatment group who reported high levels of depressive mood before the CBT treatment were significantly less depressed 1 year after injury, compared to similar persons in the control group.
While it appears not everyone who experiences SCI needs CBT, at least in the hospital phase of their rehabilitation, those who report high levels of depressive mood benefited greatly from CBT.
尽管有许多传闻称心理干预有助于改善脊髓损伤（SCI）患者的适应情况，但几乎没有数据支持这一说法。迄今为止，很少有基于纵向研究的对照试验报告评估脊髓损伤患者的心理结果。本研究旨在确定康复期间认知行为疗法的长期疗效。
本研究采用非随机对照试验，在三个时间点进行测量：治疗前、治疗后即刻以及治疗后12个月。研究地点、结果测量指标及干预措施：对28名入院时连续入选的脊髓损伤患者进行焦虑、抑郁情绪和自尊评估，这些患者在康复期间参加了专门的团体认知行为疗法（CBT）。
将干预组在各项测量指标上的反应与41名脊髓损伤患者组成的对照组进行比较，对照组在住院期间仅接受传统康复服务。
在焦虑、抑郁情绪和自尊方面，两组总体上没有差异，尽管治疗组在抑郁评分上随时间推移的改善程度与对照组相比有更大的趋势。然而，与对照组中类似情况的患者相比，治疗组中在认知行为疗法治疗前报告抑郁情绪水平较高的患者在受伤1年后抑郁程度明显减轻。
虽然似乎并非每个脊髓损伤患者都需要认知行为疗法，至少在康复的住院阶段是这样，但那些报告抑郁情绪水平较高的患者从认知行为疗法中受益匪浅。
