認知行為團體治療對女性門診憂鬱症患者的療效

Effect of Cognitive-behavioral Group Therapy for Female Outpatients with Depressive Disorder

10.29478/TJP.200803.0005

陳偉任(Wei-Jen Chen)；鄭琇分(Chiou-Fen Chang)；周立修(Li-Shiu Chou)；周煌智(Huang-Chih Chou)；林耕新(Keng-Shin Lin)

認知行為團體 ； 憂鬱 ； 低落性情感疾患 ； 治療效果 ； cognitive-behavioral group ； depression ； dysthymic disorder ； efficacy

台灣精神醫學

22卷1期（2008 / 03 / 01）

37 - 46

繁體中文

目的：本研究的目的是希望透過實證研究，探討認知行為團體治療對女性門診憂鬱症患者之非理性信念及憂鬱情緒的改善，並建構一套適合女性門診憂鬱症患者之認知行為治療團體方案。方法：參照美國史丹福大學認知行為團體治療操作手冊翻譯而成之中文手冊，進行為期兩年的前驅研究，並做部分修改以適合本國國情及健保制度下的團體方案。研究對象為門診罹患低落性情感疾患之女性患者共29人（研究組14人，對照組15人），兩組成員於研究前、研究後以及追蹤測驗，皆接受「簡式認知型態測驗」、「簡式認知錯誤問卷」及「貝克憂鬱量表」三種量表之測試。結果：完成研究者共有23人，研究組在接受治療後，憂鬱情緒及非理性信念有顯著改善，且在後續追蹤仍有持續的療效。結論：這套認知行為團體方案之療效有其穩定性，足以提供醫療人員除了藥物治療外，另一種適合女性門診憂鬱症患者的治療模式。

Objectives: The present study was designed to verify efficacy of cognitive-behavioral group therapy (CBGT) in reducing irrational belief and depression symptoms among female outpatients with depressive disorder and to help develop a program of CBGT that can be applied in clinics. Methods: Twenty-nine female patients meeting the DSM-IV criteria for dysthymic disorder were assigned to either 10 weekly CBGT sessions (treatment group, n=14) or a waiting list (control group, n=15). The group leader was a psychiatrist. Based on the Stanford cognitive group therapeutic program, an appropriate program was developed that could be applied in a clinic. The two groups were followed for two months and the following outcome measures were applied: Beck's depression inventory, the Chinese version of the cognitive style test and the cognitive error questionnaire. These measures were used on three occasions, two weeks before the study, immediately upon completion of therapy and two months after completion of therapy. All the participants who completed the program underwent the pretest, posttest and follow-up assessments. Results: Twenty-three female patients completed the research program (treatment group, n=11; control group, n=12). The results suggest that CBGT is effective in reducing the intensity of depression symptoms and irrational beliefs. The results also show that the levels of psychopathological symptoms remain relatively stable over the two months follow-up after treatment. Conclusion: These findings can be taken as further evidence supporting the efficacy of CBGT in the treatment of depressive disorder.

1. Chu ML,Thun MS,Shu YH(2005).Application of rational-emotive behavior therapy in a patient with panic and depressive disorder.Taiwanese J Psychiatry,19,324-330.
   連結：
2. Abraham IL,Neundorfer MM,Corrie LJ(1992).Effects of group interventions on cognition and depression in nursing home residents.Nurs Res,41,196-202.
3. Arean PA,Gum A,McCulloch CE,Bostrom A,Gallagher-Thomposon L(2005).Treatment of depression in low-income older adults.Psychol Aging,20,601-609.
4. Blackburn IM,Eunson KM(1988).Acontent analysis of thoughts and emotions elicited from depressed patients during cognitive therapy.Brit J Med Psychol,62,23-33.
5. Chen TH,Lu RB,Chang AJ,Chu DM, Chou KR(2006).The evaluation of cognitive-behavioral group therapy on patient depression and self-esteem.Arch Psychiatr Nurs,20,3-11.
6. Emslie G,Kratochvil C,Vitiello B(2006).Treatment for Adolescents with Depression Study (TADS): safety results.J Am Acad Child Adolesc Psychiatry,45,1440-1455.
7. Franco V,Ian F,Nicola, V(2006).Effectiveness of cognitive-behavioral group therapy for inpatients.Clin Pract Epidemiol Mental Health,2,16.
8. Hyun MS,Chung HI,Lee YJ(2005).The effect of cognitive-behavioral group therapy on the self-esteem, depression, and self-efficacy of runaway adolescents in a shelter in South Korea.Appl Nurs Res,18,160-166.
9. Kaltenthaler E,Brazier J,De Nigris E(2006).Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation.Health Technol Assess,10,161-168.
10. Martinsen EW,Olsen T,Tonset E,Nyland KE,Aarre TF(1998).Cognitive-behavioral group therapy for panic disorder in the general clinical setting: a naturalistic study with 1-year follow-up.J Clin Psychiatry,59,437-442.
11. Miranda J,Green BL,Krupnick JL,Chung J,Siddique J,Belin T,Revicki D(2006).One-year outcomes of a randomized clinical trial treating depression in low-income minority women.J Consult Clin Psychol,74,99-111.
12. Muris P,Messters C,van Melick M(2002).Treatment of childhood anxiety disorders: a preliminary comparison between cognitive-behavioral group therapy and a psychological placebo intervention.J Beh Ther Exper Psychiatry,33,143-158.
13. Volpato CA,Heldt E,Braga BD(2003).Cognitive-behavioral group therapy in obsessive-compulsive disorder: A randomized clinical trial.Psychother & Psychosom,72,211-216.
14. Wang C,Jia F,Fang R,Zhu Y,Huang Y(1999).Comparative study of rational-emotive therapy for 95 patients with dysthymic disorder.Chinese Mental Health J,13,172-173.
15. 吳佳璇、林信男(2001)。療效不佳的憂鬱症。當代醫學，28，34-36。
16. 林梅鳳(2001)。博士論文(博士論文)。國立彰化師範大學輔導與諮商學系。
17. 柯慧貞、孫苑庭、林木芬、葉宗烈、陸汝斌(2001)。由行為抑制探討婦女焦慮與憂鬱之共病機制。台灣精神醫學，14，13-21。
18. 袁美雲(1998)。理情團體諮商對國小教師理性信念及情緒穩定之諮商效果研究。屏東師院國民教育研究所論文集，2，91-133。
19. 商志雍、廖士程、李明濱(2003)。精神科門診憂鬱症患者就診率之變遷。台灣醫學，7，502-508。
20. 張杉義(2004)。碩士論文(碩士論文)。台北市立師範學院國民教育研究所。
21. 郭志通(2001)。憂鬱症之診斷標準與協助治療策略。諮商與輔導，181，14-18。
22. 陳信任、楊聰財、陸汝斌、張敏(2001)。抗鬱劑誘發之躁症發作。醫學研究，21，1-8。
23. 陳純誠(2001)。重鬱症生理病理機轉。台灣精神醫學，15，3-14。
24. 陳逸群譯(2001)。艾里斯：理情治療學派創始人。台北:生命潛能文化。
25. 曾秋琪(1999)。理情團體諮商對國小低學業成就生學業自我概念之影響。屏東師院國民教育研究所論文集，4，325-354。
26. 曾美智、李宇宙、李明濱(1999)。憂鬱症與焦慮症之共患現象。台灣精神醫學，13，125-135。
27. 黃正仁、鄭英耀(1996)。理情團體學習課程對中年家庭主婦非理性觀念與健康狀態之影響。教育與心理研究，20，181-201。
28. 楊庸一(2000)。輕型精神疾病之治療 (2) 憂鬱症之診斷。當代醫學，27，52-54。

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