生活与社交技能训练在老年双相障碍缓解期患者中的应用

李永妹; 王建女

doi:10.16766/j.cnki.issn.1674-4152.002689

生活与社交技能训练在老年双相障碍缓解期患者中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002689

李永妹,
王建女^,

浙江大学医学院附属精神卫生中心，杭州市第七人民医院老年二科，浙江杭州 310013

基金项目:

浙江省医药卫生科技计划项目 2020KY745

详细信息

通讯作者:
王建女, E-mail: 1476810580@qq.com

中图分类号: R749.05R749.4
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- 被引次数: 0
出版历程
- 收稿日期: 2022-01-18
- 网络出版日期: 2022-11-30

Application of life and social skill training in elderly patients with bipolar disorder in remission stage

LI Yong-mei,
WANG Jian-nyu^,

Second Department of the Elderly, Hangzhou Seventh People' s Hospital, Mental Health Center Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang 310013, China

摘要

摘要: 目的探讨生活与社交技能训练对老年双相障碍缓解期患者情感症状、总体功能及认知功能的影响。方法选择2018年1月—2021年1月杭州市第七人民医院收治的106例老年双相障碍缓解期患者，采用随机数字表法分为研究组(生活与社交技能训练+常规护理组)和对照组(常规护理组)，各53例。治疗8周，研究组43例、对照组52例患者完成治疗。治疗前后采用汉密尔顿抑郁量表 17项版(HAMD-17)、杨氏躁狂评定量表(YMRS)、功能检测简版(FAST)、威斯康星卡片分类检测(WCST)评估2组患者情感症状、总体功能及认知功能。结果治疗后，研究组HAMD-17[(3.233±1.280)分]、YMRS[(2.411±0.502)分]评分均低于对照组[(4.193±1.317)分、(3.119±0.612)分]，差异均有统计学意义(t=3.577、6.118，均P＜0.05)。在总体功能方面，治疗后研究组FAST总分、自主生活评分、认知功能评分均低于对照组，差异均有统计学意义(均P＜0.05)。在认知功能方面，治疗8周后研究组正确应答数目、完成分类数目均较对照组高，研究组错误应答数目以及持续错误数目均少于对照组，差异均有统计学意义(均P＜0.05)。结论生活与社交技能训练可改善老年双相情感障碍缓解期患者的残留情感症状，促进总体功能、认知功能的提高。
- 生活与社交技能训练 /
- 老年 /
- 双相障碍缓解期患者 /
- 情感症状 /
- 总体功能 /
- 认知功能
Abstract: Objective To investigate the effect of life and social skills training on affective symptoms, overall function, and cognitive function in elderly patients with bipolar disorder in remission stage. Methods A total of 106 elderly patients with bipolar disorder in remission stage from January 2018 to January 2021 in Hangzhou Seventh People' s Hospital were selected. They were randomly divided into the study group (life and social skill training + routine-nursing group) and control group (routine-nursing group) by using the random-number-table method, with 53 cases in each group. After 8 weeks, 43 and 52 patients in the study and control groups, respectively, completed the treatment. Before and after treatment, the 17-item Hamilton rating scale for depression (HAMD-17), Young manic rating scale (YMRS), functioning assessment short test (FAST), and Wisconsin card sorting test-modified (WCST) were used to evaluate the affective symptoms, overall function, and cognitive function of the two groups of patients. Results After treatment, the HAMD-17 [(3.233±1.280) points] and YMRS [(2.411±0.502) points] scores of the study group were lower than those in the control group [(4.193±1.317) points, (3.119±0.612) points], and the differences were statistically significant (t=3.577, 6.118, all P < 0.05). In terms of overall function, after treatment, the total score of FAST, autonomous life score, and cognitive function score in the study group were lower than the control group' s score, and the differences were statistically significant (all P < 0.05). In terms of cognitive function, after 8 weeks of treatment, compared with the control group, response corrects (Rc) and categories completed (Cc) in the study group were higher, and response errors (Re) and response perseverative errors (Rpe) in the study group were lower, with statistical significance (all P < 0.05). Conclusion Life and social skill training can improve the residual affective symptoms of elderly patients with bipolar disorder in remission stage, as well as promote the improvement in overall function and cognitive function.
- Life and social skills training /
- Elderly /
- Patients with bipolar disorder in remission stage /
- Affective symptoms /
- Overall function /
- Cognitive function

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表 1 2组老年双相障碍缓解期患者一般资料比较

Table 1. Comparison of general data between two groups of elderly patients with bipolar disorder in remission stage

组别	例数	年龄(x±s，岁)	性别(例)		病程(x±s，年)
组别	例数	年龄(x±s，岁)	男性	女性	病程(x±s，年)
研究组	43	65.223±4.173	19	24	24.451±6.308
对照组	52	66.025±3.646	22	30	26.712±7.488
统计量		1.009^a	0.034^b		1.570^a
P值		0.315	0.854		0.120
注：^a为t值，^b为χ²值。

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表 2 2组老年双相障碍缓解期患者治疗前后HAMD-17及YMRS评分比较(x±s，分)

Table 2. Comparison of HAMD-17 and YMRS scores between two groups of elderly patients with bipolar disorder in remission stage before and after treatment (x±s, points)

组别	例数	HAMD-17		YMRS
组别	例数	治疗前	治疗后	治疗前	治疗后
研究组	43	4.912±1.503	3.233±1.280^a	3.583±0.756	2.411±0.502^a
对照组	52	4.817±1.645	4.193±1.317^a	3.451±0.829	3.119±0.612^a
t值		0.276	3.577	0.789	6.118
P值		0.783	＜0.001	0.432	＜0.001
注：与同组治疗前比较，^aP＜0.05。

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表 3 2组老年双相障碍缓解期患者治疗前后FAST评分比较(x±s，分)

Table 3. Comparison of FAST scores between two groups of elderly patients with bipolar disorder in remission stage before and after treatment (x±s, points)

组别	例数	FAST总分		自主生活方面			职业功能方面			认知功能方面
组别	例数	治疗前	治疗后	治疗前	治疗后		治疗前	治疗后		治疗前	治疗后
研究组	43	39.254±8.291	33.443±8.163	5.712±1.693	3.123±1.454		9.867±2.009	9.258±1.723		6.321±1.704	5.214±1.737
对照组	52	38.736±9.022	36.872±7.808	5.530±1.234	4.065±1.533		9.762±1.890	9.763±1.891		6.687±1.489	6.791±1.847
t值		0.284	2.088	0.600	3.084		0.274	0.817		1.130	4.256
P值		0.777	0.040	0.550	0.003		0.784	0.416		0.261	＜0.001

组别	例数	钱财问题方面			人际关系				休闲方面
组别	例数	治疗前	治疗后		治疗前	治疗后			治疗前	治疗后
研究组	43	4.019±0.551	3.518±0.430		9.724±1.747	8.903±1.822			3.611±0.428	3.607±0.429
对照组	52	6.791±1.854	3.482±0.536		9.507±1.677	9.509±1.683			3.469±0.303	3.562±0.441
t值		1.919	0.393		0.595	1.562			1.863	1.347
P值		0.058	0.695		0.553	0.122			0.660	0.181

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表 4 2组老年双相障碍缓解期患者治疗前后WCST结果比较(x±s，数目)

Table 4. Comparison of WCST between two groups of elderly patients with bipolar disorder in remission stage before and after treatment (x±s, numbers)

组别	例数	Ra		Rc		Re		Rpe		Cc
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
研究组	43	116.533±7.352	111.562±8.979	66.558±5.454	78.782±6.156	49.974±9.581	32.780±9.843	12.378±4.081	10.276±4.450	4.731±0.899	5.320±0.433
对照组	52	118.671±8.214	109.555±9.390	65.022±6.284	68.501±7.088	53.645±10.774	41.062±9.569	13.141±3.782	12.704±4.109	4.693±0.372	4.937±1.084
t值		1.325	1.054	1.262	7.459	1.742	4.144	0.941	2.752	0.292	2.168
P值		0.188	0.295	0.210	＜0.001	0.085	＜0.001	0.349	0.007	0.771	0.033

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