氟西汀合并支持性心理治疗对精神分裂症后抑郁的疗效观察【摘要】目的探讨氟西汀合并支持性心理治疗对精神分裂症后抑郁的疗效及安全性。方法将96例精神分裂症后抑郁患者随机分为氟西汀联合支持性心理治疗组48例和支持性心理治疗组48例。两组在保持原治疗药物不变的基础上，研究组加用氟西汀治疗。两组均于治疗前及治疗第4、8w末采用汉密顿抑郁量表、简明精神病量表评定临床疗效，采用副反应评定量表评定不良反应。结果两组治疗8w末汉密顿抑郁量表、简明精神病量表评分均较治疗前显着下降。研究组有3例出现轻度恶心、呕吐，2例出现焦虑、睡眠差，经对症处理1w内缓解。结论氟西汀治疗精神分裂症后抑郁疗效好、安全性高、服药依从性好。【关键词】精神分裂症；抑郁；氟西汀；心理治疗Aclinicalstudyoffluoxetinecombinedwithsupportivepsychotherapyinpostschizophreniadepression【Abstract】ObjectiveToexploretheefficacyandsafetyofflouxetinecombinedwithsupportivepsychotherapyinpostschizophreniadepression.Methods96patientswererandomlydividedintoresearch(fluoxetinecombinedwithsupportivepsychotherapy,n=48)andcontrol(supportivepsychotherapy,n=48)groups.Originallyuseddrugswereretainedforboththe2groups,fluoxetinewasaddedinresearchgroup.EfficaciesandsideeffectswereassessedwiththeHamiltonDepressionScale(HAMD),theBriefPsychiatricratingScale(BPRS)andTreatmentEmergentSymptomScale(TESS)beforetreatmentandattheendsof4thand8thweekofthetreatment,respectively.ResultsAttheendof8thweek,scoresoftheHAMDandBPRSweresignificantlydecreasedcomparedwithpretreatment(or)inboththe2groups;ThedecreasesoftheHAMDscoreandscorereducingrateweremoreobviousintheresearchthaninthecontrolgroup,differencewassignificant();ThedecreaseoftheBPRStotalscorewasmoreobviousintheresearchthaninthecontrolgroup,differencewasnotsignificant().Intheresearchgroup,3patientsshowedmildnauseaandvomitingand2onesdidanxietyandbadsleep,afterexpectanttreatmentallthosesymptomsremitted.ConclusionFluoxetinehasbetterefficacy,highersafetyandbetterpatients‘complianceinthetreatmentofpostschizophrenicdepression.【Keywords】Schizophrenia;depression;fluoxetine;psychotherapy精神分裂症后抑郁系指精神分裂症病情好转后出现的抑郁症状。近年研究发现其发生与心理因素有关。作者采用氟西汀联合支持性心理治疗对精神分裂症后抑郁进行临床观察，县将结果报告如下。1对象与方法1对象病例选自2002年2月～2003年4月我院住院的96例精神分裂症后抑郁患者。其中男51例，女45例，平均年龄±，平均病程±。服用氯氮平48例，氯丙嗪、奋万静、舒必利等30例，利培酮8例。所服药物均为维持治疗量。入组标准：符合《中国精神障碍分类与诊断标准》第3版精神分裂症诊断标准；经住院治疗病情明显好转，自知力大部分恢复，能坚持服药；病程中出现抑郁症状，汉密顿抑郁量表评分≥17分，简明精神病量表总分＜35分；排除其他严重躯体疾病，无精神活性物质依赖史，无氟西汀过敏史；入组前心电图，血、尿常规，肝、肾功能检查