目的 研究心理治疗结合康复治疗对脑损伤患者抑郁障碍的效果,分析相关心理应激源的影响。方法 收集2015年10月至2017年12月本院心理科接受心理治疗的脑损伤并发抑郁障碍患者62例,其中脑出血21例,脑梗死22例,脑外伤19例。均属于亚急性期。患者因身体功能障碍接受常规康复治疗,同时进行心理治疗。治疗过程持续2周。干预前和干预2周后由心理治疗师进行汉密尔顿抑郁量表(HAMD)评价,参照ICF TBI核心分类工具对心理应激源进行系统分析。结果 干预2周后,HAMD评分由(22.96±8.46)显著下降到(15.40±7.53)(t=11.709, P<0.001)。研究发现,与身体功能变化有关的因素包括精神稳定性、乐观、精力程度和动机等;与心理和情绪相关的身体功能因素有注意力、心理运动功能和情绪调节功能等;在活动和参与方面,与抑郁情绪有关的因素包含控制自身活动水平、做出决策、问题解决以及交流沟通或与家人沟通等;在环境因素方面,与抑郁有关的因素主要为家人对待自己的态度。结论 心理干预结合综合康复治疗可缓解脑损伤患者的抑郁。
Objective To explore the effect of psychological intervention combined with comprehensive rehabilitation on depression after brain injury, and to analyze the psychological stressor.Methods A total of 62 patients with brain injury following depression included 21 cases for cerebral hemorrhage, 22 cases for cerebral infarction, and 19 cases for traumatic brain injury in our hospital from October, 2015 to December, 2017. The patients received comprehensive rehabilitation and psychological intervention for two weeks. They were assessed by the psychologist with Hamilton Rating Scale of Depression (HAMD) before and two weeks after intervention. The effect of all interventions was analyzed on the related psychological stressors on the base of ICF TBI coreset.Results The score of HAMD significantly decreased from (22.96±8.46) to (15.40±7.53) (t=11.709, P<0.001).Conclusion Psychological intervention combined with comprehensive rehabilitation can relieve the depression of brain injured patients.
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