关键词: 抑郁症, 病人依从, 病耻感, 知行分析疗法

Abstract: Background　Major depressive disorder（MDD）patients often suffer from severe stigma and low treatment compliance，which leads to the failure of effective control of the disease and even aggravates the symptoms of depression.Psychotherapy should be carried out to reduce the stigma of patients and improve treatment compliance while treating depression.Objective　To observe the effects of perceptional and behavioral analysis therapy（PBAT）on the treatment compliance，stigma and depressive symptoms in patients with MDD．Methods　Seventy-five MDD outpatients were selected from Department of Clinical Psychology，Subei People's Hospital Affiliated to Yangzhou University from January 2017 to January 2018.They were divided into study group（38 cases）and control group（37 cases）by use of a random number table method，receiving personalized 50-minute PBAT（totaled 8 times，performed according to the treatment regimen），conventional psychological education，respectively，on the basis of treatment with citalopram（an antidepressant drug belonging to the selective 5-serotonin reuptake inhibitors）．Basic demographic characteristics were collected.Treatment adherence，stigma，and depressive symptoms were assessed by the 8-item Morisky Medication Adherence Scale（MMAS-8），Scale of Stigma（SS），24-item Hamilton Depression Scale（HAMD-24），respectively，at baseline and the end of 8-week treatment.Treatment effect was evaluated by the HAMD-24 when the 8-week treatment ended．Results　The scores of MMAS-8 were much higher in the study group than those of the control group（P<0.05）．The scores of MMAS-8 were higher in the study group after treatment than before treatment（P<0.05）．The treatment compliance after treatment of the study group was better than that of the control group（P<0.05）．The treatment compliance improved significantly in both groups（P<0.05）．After treatment，the scores of SS and its 3 dimensions（sociality，ability and therapeutic dimensions）decreased significantly in the study group compared with baseline（P<0.05），and they were much lower in the study group compared with those of the control group（P<0.05）．After treatment，the scores of HAMD-24 decreased significantly in both groups compared with baseline（P<0.05），and they were much lower in the study group compared with those of the control group（P<0.05）．The treatment effect of the study group was better than that of the control group（P<0.05）．Conclusion　PBAT can effectively increase the treatment compliance of MDD patients，relieve the depressive symptoms and improve the treatment effects.

Key words: Depressive disorder, Patient compliance, Stigma, Perceptional and behavioral analysis therapy