团体回忆疗法对老年糖尿病合并轻中度抑郁患者抑郁症状、认知功能及生活质量的影响

Effect of group reminiscence therapy on depressive symptoms， cognitive function， and quality of life in elderly patients with diabetes and mild to moderate depression

中文关键词:  团体回忆疗法  糖尿病  抑郁  认知功能  生活质量

英文关键词:Group reminiscence therapy  Diabetes  Depression  Cognitive function  Quality of life

中文摘要:

      背景 老年糖尿病患者抑郁症状的发生率较高，早期进行心理干预对改善其临床预后具有重要意义。既往多采用认知行为治疗、人际心理疗法等对老年糖尿病患者的抑郁症状进行干预，而患者的认知功能水平可能会限制这些干预方法的实施。目前，采用团体回忆疗法改善老年糖尿病患者抑郁症状的相关研究有限。目的 探索团体回忆疗法对老年糖尿病合并轻中度抑郁患者抑郁症状、认知功能及生活质量的影响，以期为老年糖尿病患者的心理干预方法选择提供参考。方法 本研究为随机对照研究。选取2022年6月—2023年12月在东北国际医院内分泌科门诊治疗的80例老年糖尿病合并轻中度抑郁患者为研究对象，使用随机数字表法将患者分为研究组和对照组各40例。两组均接受糖尿病常规治疗及心理健康教育，研究组在此基础上接受为期8周、每周1次、每次1.5 h的团体回忆疗法干预。于干预前和干预后，采用汉密尔顿抑郁量表24项版（HAMD-24）评定抑郁症状，采用威斯康辛卡片分类测试（WCST）、词语流畅性测验（VFT）、Stroop色词测验（SCWT）评定认知功能，采用生活质量综合评定问卷（GQOLI-74）评定生活质量。结果 干预后，研究组HAMD-24评分低于对照组，差异有统计学意义（F=13.908，P<0.01）；研究组WCST正确应答百分比、WCST概念化水平百分数、VFT正确数、SCWT正确数均高于对照组，差异均有统计学意义（F=14.672、17.000、13.309、21.672，P均<0.01）；研究组GQOLI-74心理功能维度评分、社会功能维度评分、物质生活维度评分以及总评分均高于对照组，差异均有统计学意义（F=33.098、41.224、16.320、19.432，P均<0.01）。结论 团体回忆疗法可能有助于改善老年糖尿病合并轻中度抑郁患者的抑郁症状、认知功能及生活质量。

英文摘要:

      Background The prevalence of depression is elevated in elderly patients with diabetes， underscoring the critical importance of implementing early psychological intervention to improve their clinical outcomes.However， the cognitive function level of patients may limit the implementation of these intervention methods. While prior research has predominantly focused on interventions such as cognitive behavioral therapy and interpersonal psychotherapy to mitigate the depressive symptoms in this demographic， the exploration of group reminiscence therapy as a therapeutic approach remains underrepresented in the existing literature.Objective To investigate the effect of group reminiscence therapy on depressive symptoms， cognitive function， and quality of life in elderly patients with diabetes and mild to moderate depression， so as to provide valuable insights for psychological intervention of elderly diabetic patients.Methods A randomized controlled trial was conducted to recruit 80 elderly diabetic patients with mild to moderate depression attending the endocrine clinic of Northeast International Hospital from June 2022 to December 2023. Subjects were randomly allocated to either the study group or the control group using the random number table method， with 40 cases in each group. Both groups received standard diabetes care and mental health education. Additionally， the study group participated in an 8-week group reminiscence therapy intervention， convening once weekly for 1.5 hours per session. Hamilton Depression Scale-24 item （HAMD-24）， Wisconsin Card Sorting Test （WCST）， Verbal Fluency Test （VFT）， Stroop Color Word Test （SCWT） and Generic Quality of Life Inventory-74 （GQOLI-74） were administered before and after intervention.Results After intervention， the study group exhibited a significantly lower HAMD-24 score compared with the control group （F=13.908， P<0.01）. The study group also demonstrated better performance in cognitive assessments， as evidenced by increased percentages of correct responses and conceptual-level responses on the WCST， a greater number of correct words on the VFT， and a higher number of accurate responses on the SCWT， all in contrast to the control group （F=14.672， 17.000， 13.309， 21.672， P<0.01）. The study group reported superior quality of life outcomes， with higher total GQOLI-74 scores and significant improvements in the domains of physical function， social function， psychological function， and material life status compared with the control group （F=33.098， 41.224， 16.320， 19.432， P<0.01）.Conclusion Group reminiscence therapy has the potential to alleviate depressive symptoms， enhance cognitive function and improve quality of life in elderly diabetic patients with mild to moderate depression.