摘要
目的探讨在线失眠认知行为治疗(e-aid cognitive behavioral therapy for insomnia, eCBTI)对不同年龄段情境性失眠患者的疗效和依从性。方法 2020年3月至4月在广东省广州市不同社区通过"预防和保护手册"招募受试者, 纳入194例情境性失眠患者, 以年龄35岁为分界点, 将受试者分为<35岁组(n=87)和≥35岁组(n=107)。两组同时接受为期1周的eCBTI干预。干预前后, 通过失眠严重程度指数(insomnia severity index, ISI)、睡前觉醒量表(pre-sleep arousal scale, PSAS)和医院焦虑抑郁量表(hospital anxiety and depression scale, HADS)评估受试者病情严重程度的变化。采用SPSS 21.0进行t检验和单因素方差分析对组内各量表变化情况及组间减分率进行统计分析。结果 (1)干预疗效:在<35岁组, 与基线相比, 干预后ISI量表总分为[(9.2±4.1)分, (14.8±5.1)分], PSAS认知觉醒量表分为[(18.5±8.4)分, (23.5±6.6)分] 、PSAS量表总分[ (34.3±15.8)分, (40.3±10.7)分]、HADS抑郁分量表分为[(5.8±3.6)分, (8.5±4.6)分]、HADS焦虑分量表分为[(7.1±3.9)分, (9.5±4.5)分] , 均差异有统计学意义(t=2.88~8.80, 均P<0.01);PSAS躯体量表分[ (15.8±7.8)分, (16.8±5.7)分]差异无统计学意义(P>0.05)。在≥35岁组, 与基线相比, 干预后ISI量表总分为[(9.7±4.2)分, (14.4±4.3)分]、HADS抑郁分量表分为[(4.6±2.2)分, (6.6±3.5)分] 、PSAS认知觉醒量表分为[(16.9±8.5)分, (20.0±5.8)分]差异有统计学意义(t=2.90~6.86, 均P<0.01);PSAS躯体量表分[ (14.3±8.0)分, (13.9±5.2)分]、PSAS量表总分[(32.2±16.5)分, (33.9±9.2)分]、HADS焦虑分量表分为[(6.1±3.2)分, (7.0±3.5)分] , 差异无统计学意义(均P>0.05)。干预前后两组减分率差异无统计学意义(均P>0.05)。(2)依从性:脱落率31.8%(194/280), 完整完成7 d线上治疗75例(38.7%), 完成1~6 d线上治疗119例(61.3%), 进一步研究发现依从性优、良、差三组ISI总分减分率差异有统计学意义(F=5.655, P=0.004)。结论
Objective To explore the efficacy and compliance of e-aid cognitive behavioral therapy(eCBTI)in patients with situational insomnia among different age groups.Methods A total of 194 patients with situational insomnia were recruited via a campaign of the"Prevention and Protection Handbook Against Epidemic"from March to April 2020 in Guangzhou,China.Participants were divided into two groups according to age:under 35 years old(n=87)and 35 years old and above(n=107).They all received one-week eCBTI intervention.Insomnia severity index(ISI),Pre-sleep arousal scale(PSAS)and Hospital anxiety and depression scale(HADS)were used to evaluate the severity of insomnia for all participants pre-and post-intervention.The change of each scale within the group and the reduction rate of each scale between groups were compared using t test and one-way ANOVA.Results(1)Intervention efficacy:in the<35-year-old group,compared with baseline,the scores of ISI scale((9.2±4.1),(14.8±5.1)),PSAS cognitive arousal subscale((18.5±8.4),(23.5±6.6)),PSAS((34.3±15.8),(40.3±10.7)),HADS depression subscale((5.8±3.6),(8.5±4.6))and HADS anxiety subscale((7.1±3.9),(9.5±4.5))were statistically significant after eCBTI intervention(t=2.88-8.80,all P<0.01),but there was no significant difference in score of PSAS body subscale((15.8±7.8),(16.8±5.7)).In≥35-year-old group,compared with baseline,the scores of ISI scale((9.7±4.2),(14.4±4.3)),HADS depression subscale((4.6±2.2),(6.6±3.5))and PSAS cognitive arousal subscale((16.9±8.5),(20.0±5.8))were significantly different after intervention(t=2.90-6.86,all P<0.01),meanwhile the scores of PSAS body subscale((14.3±8.0),(13.9±5.2)),PSAS((32.2±16.5),(33.9±9.2)),HADS anxiety subscale((6.1±3.2),(7.0±3.5))were not statistically significant(all P>0.05).There was no significant difference in the score reduction rate between the two groups before and after intervention(all P>0.05).(2)Compliance:86 cases dropped out,and the dropout rate was 61.3%.Totally 75 cases(38.7%)completed the 7-day treatment
作者
许艳
曾淑妃
张陈茜
谢丽凯
林连虹
张黎黎
刘兴昌
张斌
Xu Yan;Zeng Shufei;Zhang Chenxi;Xie Likai;Lin Lianhong;Zhang Lili;Liu Xingchang;Zhang Bin(Department of Psychiatry,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Health Management Center of Shenzhen Hospital,Southern Medical University,Shenzhen 518000,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2022年第9期846-851,共6页
Chinese Journal of Behavioral Medicine and Brain Science
基金
国家自然科学基金(82071488)
广东省科技计划项目(2017B020227010)
南方医院院长基金(2019Z014)。
关键词
情境性失眠
在线失眠认知行为治疗
年龄
依从性
疗效
Situational insomnia
e-aid cognitive behavioral therapy for insomnia(eCBTI)
Age group
Compliance
Efficacy
