目的:观察认知行为疗法（CBT）联合舍曲林药物治疗对抑郁症的临床疗效。方法:抑郁症患者62例,随机分为2组各31例,药物组给予口服抗抑郁药物舍曲林治疗,联合组此基础上联合认知自动思维,列举认知歪曲,改变极端的信念或原则等CBT治疗。治疗前后采用汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）评定临床疗效。结果:治疗4及8周末,2组HAMD及HAMA评分均较治疗前呈下降趋势（P＜0.05）,但联合组更低于对照组（P＜0.05）。治疗后随访8个月,联合组HAMD及HAMA评分仍显著低于药物组（P＜0.01）。结论:认知行为疗法可显著提高抑郁症患者的治疗效果,且远期疗效较好。

Objective To explore the effect of cognitive behavior therapy(CBT) on sleep quality and mental health of insomnia patients.Methods A total of 72 patients with insomnia of CCMD-3 were adapted,of which 36 cases forming drug group were given zopiclone,and 36 cases forming combined treatment group were given the administration of zopiclone combined with cognitive behavior therapy for 8 weeks.Before and after treatment Symptom Checklist 90(SCL-90) was conducted for mental health evaluation,and the Pittsburgh Sleep Quality Index(PSQI) for clinical evaluation.Results After treatment,those SCL-90 scores of somatization(t=2.682,P<0.01),interpersonal sensitivity(t=2.685,P<0.01),obsessive-compulsive symptoms(t=2.983,P<0.01),depression(t=2.045,P<0.05),anxiety(t=2.650,P<0.01),in the drug group were significantly higher than those in combined treatment group;the combined treatment group scored significantly lower than the drug group in Pittsburgh sleep quality(t=2.366,P<0.05),sleep time(t=2.398,P<0.05),sleep efficiency(t=2.176,P<0.05),sleep medication(t=2.060,P<0.05).Conclusion Cognitive behavioral therapy can improve the mental health of patients with insomnia and their sleep quality mood symptoms and reduce side effects.

<正>精神分裂症病人经过系统住院治疗后进入维持期(康复期)治疗,有的需长期甚至终身的治疗和支持,绝大多数病人与亲属生活在一起。有报道表明,精神分裂症病人亲属对精神疾病知识了解越多,越能降低病人的复发率[1]。我科通过对出院病人进行跟踪电话回访,发现他们的亲属缺乏科学的看护知识,尤其

OBJECTIVE: To investigate the use of antipsychotics in the schizophrenic inpatients in Shandong Zibo Mental Health Center.METHODS: The use of antipsychotics in the schizophrenic inpatients was investigated by using one-day survey method.RESULTS: Single use of antipsychotics took the lead with 62.96%;Clozapine took the first place in terms of DDDs,and the doses of antipsychotics were all within the recommended safe dosage range.CONCLUSION: The use of antipsychotics in our hospital is generally rational yet far from perfect.The drug utilization review should be conducted periodically to improve rational drug use level.

Objective To explore the efficacy of cognitive behavior therapy(CBT) and taking zopiclone on sleep quality and mental health of patients with insomnia.Methods A total of 64 patients with insomnia chosen for CCMD3 were randomly divided into drug group and cognitive behavioral therapy group,both groups were treated for 8 weeks,sleep quality and mental health were tested before and after treatment.Results After treatment,there were significant differences in somatization(t=2.683,P<0.01),interpersonal sensitivity(t=2.151,P<0.05),depression(t=2.057,P<0.05),anxiety(t=2.144,P<0.05),obsessive-compulsive symptoms(t=2.031,P<0.05),CBT group scores were significantly lower than drug group;in PSQI sleep time(t=2.459,P<0.05),drug group scored lower significantly than CBT group.Conclusion Cognitive behavioral therapy has a good therapeutic effect in improving sleep quality of patients with insomnia.

目的探讨长期住院老年精神分裂症患者的认知功能状况.方法采用日常生活活动能力量表(ADL)简易智力状态检查表(MMSE),对住院10年以上,病期15年以上,年龄55岁的精神分裂症病人及间断住院、门诊取药治疗的对照组病人进行测试.结果MMSE研究组(12.42±5.68)分,对照组(17.63±4.85)分;ADL研究组(38.26±9.35)分,对照组(31.50±6.38)分,差异有显著性.结论长期住院老年精神分裂症病人,较非长期住院的对照组病人,有明显的认知功能缺陷.

本刊编辑部综合 编辑:本期继续报道有关精神药物副反应及其处理,是根据16个单位31位作者所写的21篇稿件综合而成的.

目的:探讨首诊为分裂情感性精神病(SAP)患者的转归及预后.方法:对50例首次住院诊断为SAP的患者,经5年随访观察进行对照研究.结果:50例SAP患者中,19例改诊为情感性障碍(Ma),10例改诊为精神分裂症(Sc),21例维持原诊断.以上3组在病前性格及发病诱因方面有显著差异.在近期疗效、缓解时间及5年后社会功能恢复情况看,Ma最好,SAP次之,Sc最差.结论:SAP是一个发病率较低、预后较好的独立的疾病单元.