严重精神障碍主要照料者抑郁现状及干预研究

Mental Status of family caregiver for severe mental disorder patients

摘要:

目的??了解严重精神障碍主要照料者抑郁现状及影响因素，探讨其心理干预效果。方法??随机抽 取新乡市在管严重精神障碍患者的主要照料者 300 人，随机分为干预组和对照组。干预组患者主要照料者接 受精神科主治医师的心理干预，主要采用集中讲座和活动讨论的方式，1 次 / 月，为期半年。干预前后所有对象 均接受抑郁自评量表测试，影响因素采用 Logistic 回归分析。结果??严重精神障碍主要照料者抑郁倾向阳性率为 75.67% ； 主要照料者不同年龄、职业、性别、文化程度及与患者关系等因素间抑郁倾向阳性率比较，差异有统 计学意义（ P <0.05） ； 经多因素 Logistic 回归分析，主要照料者年龄增加、文化程度加深、病程的迁移及女性是 主要照料者抑郁倾向的高危因素。高人均纯收入、与患者关系疏远及医疗费用支付方式公费为保护性因素。干 预后干预组抑郁自评量表得分低于对照组（ P <0.05） ，同组比较，干预组干预后得分低于干预前（ P <0.05） 。结论??严重精神障碍主要照料者心理现状较差，抑郁倾向阳性率较高，心理干预能够有效改善患者主要照料者心理状况。

Abstract:

Objective To understand the mental status of family caregivers for severe mental disorder patients and potential interventions for depression of caregivers. Methods Totally 300 family caregivers for severe mental disorder patients were involved and randomly divided into intervention group (150 cases) and blank control group (150 cases). Intervention group members received psychological intervention through lecture and discusses provided by psychiatric physician monthly for 6 months. Family members received Self-Rating Depression Scale test before and after mental intervention. Logistic regression was adopted in data analysis. Results The positive rate of depressive tendency among family caregivers for severe mental disorder patients were 75.67%. Depression rate was closely associated with the age (P < 0.05), vocation (P < 0.05), sex (P < 0.05), education level (P < 0.05) and the emotional relationship with patients (P < 0.05). Agedness, high education level, female, and prolonged course were major risk factors for depression. The protective factors were high income, remote relationship with patients and free medical treatment. The depressive scores was lowered post psychiatric intervention when compared with control group or that prior to any intervention (P < 0.05). Conclusions Positive rate of depressive tendency is high among family caregivers for severe mental disorder patients. The professional psychological intervention effectively improves the psychological status of family caregivers.