林小容 林崇光 杨晓丽

[摘要] 目的 探讨正念认知干预对双相情感障碍（BAD）患者心理健康状况及生活质量的影响。 方法 选择2016年1月～2017年12月该院精神科就诊的BAD患者共100例，随机分为干预组和对照组。两组均予以丙戊酸钠片治疗，起始剂量400 mg/d，逐渐加量增至800～1600 mg/d。对照组在药物治疗基础上采用常规干预措施，干预组再加正念认知干预，两组均干预12周。观察两组干预前后心理健康状况及生活质量变化，并评估其临床效果。 结果干预12周后，两组患者SAS和SDS评分均较干预前明显下降（P<0.05或P<0.01），且干预组下降幅度较对照组更显著（P<0.05）;干预12周后，两组生活质量SF-36评分均较治疗前明显上升（P<0.05或P<0.01），且干预组上升幅度较对照组更显著（P<0.05）。 结论 正念认知干预BAD患者能明显的改善患者的心理健康状况，提高患者的生活质量。

[关键词] 双相情感障碍;正念认知干预;心理健康状况;生活质量

[中图分类号] R749.05          [文献标识码] B          [文章编号] 1673-9701（2019）09-0077-04

[Abstract] Objective To investigate the effect of mindfulness cognitive intervention on mental health status and quality of life in patients with bipolar affective disorder（BAD）. Methods A total of 100 patients with BAD who were admitted to the department of psychiatry in our hospital from January 2016 to December 2017 were selected and randomly divided into intervention group and control group. Both groups were given sodium valproate tablets.The initial dose was 400 mg/d， which was gradually increased to 800-1600 mg/d.The control group was given routine interventions based on drug treatment. The intervention group was further given mindfulness cognitive intervention， and both groups were intervened for 12 weeks. The mental health status and quality of life changes before and after intervention were observed and the clinical effects were evaluated in both groups. Results After 12 weeks of intervention， the SAS and SDS scores of the two groups were significantly lower than those before the intervention（P<0.05 or P<0.01）， and the decrease in the intervention group was more significant than that in the control group（P<0.05）; after 12 weeks of intervention， the quality of life SF-36 scores of the two groups were significantly higher than those before treatment（P<0.05 or P<0.01）， and the increase in the intervention group was more significant than that in the control group（P<0.05）. Conclusion Mindfulness cognitive intervention in the patients with BAD can significantly improve the mental health status of patients and improve their quality of life.

[Key words] Bipolar affective disorder （BAD）; Mindfulness cognitive intervention; Mental health status; Quality of life

雙相情感障碍（Bipolar affective disorder，BAD）是精神科常见疾病之一，具有患病率高、自杀率高和误诊率高等特点[1，2]。BAD可表现为抑郁、焦虑、躁狂等心理问题，目前临床上对于BAD重视不够，常误诊为单相抑郁，导致患者病情加重，引起患者社会功能和生活质量下降[3，4]。因此采用有效的药物和康复干预是改善BAD患者的心理健康和生活质量的关键措施[5，6]。正念认知干预是一种应用于情绪调节、压力缓解的干预措施，近年来逐渐应用于BAD干预治疗中[7]。本研究观察了正念认知干预对双相情感障碍患者心理健康状况及生活质量的影响，现报道如下。