With the acceleration of population aging, the incidence of senile depression is increasing year by year, which seriously threatens the physical and mental health of the elder adults. As a special group of patients, the senile depression patients are often accompanied with physical diseases. This study evaluated the antidepressant efficacy and prognostic quality of life (QoL) of cognitive-behavioral therapy (CBT) combined with low-dose Duloxetine in elderly patients of depression with comorbidities. The indicators are the clinical onset time of the antidepressant based on the Hamilton Rating Scale for Depression (HAMD), the antidepressant efficacy based on the Montgomery-Asberg Depression Rating Scale (MADRS), and the Croog QoL. The results show that the clinical effective rate (77.4%) of the treatment group at 2 weeks was significantly higher than that of the control group (60.8%) (P=0.027). The depression level of the treatment group at 1 year was lower than that of the control group (P=0.005), and the QoL of the treatment group at 1 and 1.5 years was significantly higher than that of the control group (P<0.001) (P=0.035). It suggests that the CBT combined with antidepressant can shorten the onset time, improve its efficacy and the overall function and prognostic QoL of the patients, helping them to return to social activities.
LI Ping
,
SUN Zhigang
,
XU Manhua
,
HE Lanying
,
DU Yimin
,
WANG Lifeng
,
ZHANG Pei
,
SONG Lihua
. Efficacy and advantages of cognitive-behavioral therapy in elderly depression patients complicated with physical diseases[J]. Science & Technology Review, 2024
, 42(22)
: 49
-55
.
DOI: 10.3981/j.issn.1000-7857.2024.06.00628
[1] 张硕, 马丽景, 杨赞琦, 等. 基于脑涨落图和抑郁评分系统评价中医综合治疗抑郁症的疗效[J]. 科技导报, 2023, 41(3): 51-56.
[2] Xu Y J, Yang J J, Gao J M, et al. Decomposing socioeconomic inequalities in depressive symptoms among the elderly in China[J]. BMC Public Health, 2016, 16(1): 1214.
[3] Jokelainen J, Timonen M, Keinänen-Kiukaanniemi S, et al. Validation of the Zung self-rating depression scale (SDS) in older adults[J]. Scandinavian Journal of Primary Health Care, 2019, 37(3): 353-357.
[4] 张中伟. 老年抑郁症发病机制及非药物治疗研究进展[J]. 医学理论与实践, 2019, 32(15): 2347-2348, 2338.
[5] Raič M. Depression and heart diseases: Leading health problems[J]. Psychiatria Danubina, 2017, 29(Suppl 4): 770-777.
[6] 肖腊梅, 张孟喜, 董巧亮, 等. 老年住院病人抑郁状态调查与影响因素分析[J]. 全科护理, 2017, 15(26): 3201-3203.
[7] Zhang Y X, Chen Y J, Ma L N. Depression and cardiovascular disease in elderly: Current understanding[J]. Journal of Clinical Neuroscience, 2018, 47: 1-5.
[8] Association A P. Practice guideline for the treatment of patients with major depressive disorder (revision)[J]. The American Journal of Psychiatry, 2000, 157(Suppl 4): 1-45.
[9] 李凌江. 中国抑郁障碍防治指南(第二版)解读[J]. 中华医学信息导报, 2016, 31(19): 21.
[10] 中华医学会精神病学分会. 中国精神障碍分类与诊断标准第三版(精神障碍分类) [J]. 中华精神科杂志, 2001, 34(3): 184-188.
[11] Charlton R A, Lamar M, Zhang A, et al. White-matter tract integrity in late-life depression: Associations with severity and cognition[J]. Psychological Medicine, 2014, 44(7): 1427-1437.
[12] 黄尚岗. 认知行为疗法干预治疗老年抑郁症的研究进展[J]. 中国卫生标准管理, 2023, 14(1): 195-198.
[13] Melzer J, Rostock M, Brignoli R, et al. Preliminary data of a HAMD-17 validated symptom scale derived from the ICD-10 to diagnose depression in outpatients[J]. Forschende Komplementarmedizin (2006), 2012, 19(4): 191-196.
[14] Soron T R. Validation of bangla Montgomery asberg depression rating scale (MADRSB)[J]. Asian Journal of Psychiatry, 2017, 28: 41-46.
[15] Croog S H, Levine S, Testa M A, et al. The effects of antihypertensive therapy on the quality of life[J]. The New England Journal of Medicine, 1986, 314(26): 1657-1664.
[16] 孙爱童, 高迎春, 齐岩松, 等. 基于负荷心肌声学造影评价八段锦在冠脉介入术后的康复价值[J]. 科技导报, 2023, 41(23): 28-34.
[17] 周磊, 葛丽娜, 吴琼, 等. 认知行为疗法联合文拉法辛治疗老年抑郁症的疗效及其机制[J]. 中国老年学杂志, 2023, 43(11): 2690-2693.
[18] 郑文新, 杨小慧, 刘晓彩, 等. 老年抑郁症的影响因素分析[J]. 健康教育与健康促进, 2023, 18(1): 54-58.
[19] 周晓丽, 林燕, 郑国庆. 精神疾病治疗进展(二): 抑郁症[J]. 医药导报, 2017, 36(10): 1137-1142.
[20] 姚烨, 杨春燕, 许艳秋, 等. 认知行为治疗对老年抑郁症患者认知功能改善的对照观察[J]. 国际精神病学杂志, 2020, 47(1): 67-70.
[21] Rajtar-Zembaty A, Rajtar-Zembaty J, Olszewska K, et al. Comparison of cognitive functioning of Elders with late-life depression and patients with and without a history of depressive episodes: A cross-sectional study[J]. Psychology, Health & Medicine, 2022, 27(6): 1227-1233.
[22] Tekin F, Cetisli-Korkmaz N. Effectiveness of a telerehabilitative home exercise program on elder adults' physical performance, depression and fear of falling[J]. Perceptual and Motor Skills, 2022, 129(3): 714-730.
[23] 庞羽, 刘爽. 认知行为疗法联合盐酸度洛西汀对抑郁症患者早期起效的影响及疗效观察[J]. 重庆医学, 2020, 49(22): 3720-3723.
[24] 郑书恭, 容小明, 刘楚杰. 氟哌噻吨美利曲辛片联合盐酸度洛西汀治疗卒中后抑郁的效果及安全性[J]. 中国医药科学, 2021, 11(18): 191-193, 238.
[25] 陈婷婷. 探讨艾司西酞普兰合并认知行为治疗在老年抑郁症治疗中的作用[J]. 中国医药指南, 2019, 17(14): 156-157.
[26] 张专专. 艾司西酞普兰合并认知行为治疗在老年抑郁症治疗中的作用分析[J]. 中西医结合心血管病电子杂志, 2020, 8(23): 52, 57.
[27] 陶桂凤. 观察和分析草酸艾司西酞普兰合并认知行为干预对老年抑郁症患者的治疗效果[J]. 临床医药文献电子杂志, 2018, 5(55): 160.
[28] 张加明. 米氮平合并认知行为疗法治疗老年抑郁症的对照研究[J]. 四川精神卫生, 2014, 27(2): 174-176.
[29] 李英英, 卢国强, 沈全荣, 等. 认知行为治疗对老年抑郁症患者生活质量的影响[J]. 国际精神病学杂志, 2020, 47(4): 701-704.
[30] 赵智萍. 认知行为疗法联合艾司西酞普兰对产后抑郁患者临床疗效及安全性分析[J]. 国际精神病学杂志, 2021, 48(3): 462-465.
