Effects of psychodrama combined with antidepressants on anxiety and depression, coping style and neuroimaging features in patients with major depressive disorder and childhood trauma

Peijia WANG; Erdong WANG; Renqiang YU; Xiaoyu HU; Junxin ZHOU; Jie HUANG; Xingwen XIA; Xiaomei LI; Junjun CHEN; Fajin LYU; Hua HU

doi:10.16016/j.1000-5404.201908164

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Effects of psychodrama combined with antidepressants on anxiety and depression, coping style and neuroimaging features in patients with major depressive disorder and childhood trauma

Neurosciences | 更新时间：2026-01-09

- Effects of psychodrama combined with antidepressants on anxiety and depression, coping style and neuroimaging features in patients with major depressive disorder and childhood trauma
- Journal of Third Military Medical University Vol. 42, Issue 2, Pages: 111-118(2020)
- 作者机构：
  
  1.400016 重庆，重庆医科大学附属第一医院: 精神科
  2.215006 江苏苏州，苏州大学艺术学院
  3.400016 重庆，重庆医科大学附属第一医院:放射科
- 作者简介：
- 基金信息：
  
  the Key Medical Research Project of Chongqing Health and Family Planning Commission(2016ZDXM003)
- DOI：10.16016/j.1000-5404.201908164
  CLC： R445.2;R749.055;R749.4
- Received：22 August 2019，
  
  Revised：2019-10-08，
  
  Published：30 January 2020
- 稿件说明：
移动端阅览
Peijia WANG, Erdong WANG, Renqiang YU, et al. Effects of psychodrama combined with antidepressants on anxiety and depression, coping style and neuroimaging features in patients with major depressive disorder and childhood trauma[J]. Journal of Third Military Medical University, 2020, 42(2): 111-118.
DOI：

Peijia WANG, Erdong WANG, Renqiang YU, et al. Effects of psychodrama combined with antidepressants on anxiety and depression, coping style and neuroimaging features in patients with major depressive disorder and childhood trauma[J]. Journal of Third Military Medical University, 2020, 42(2): 111-118. DOI： 10.16016/j.1000-5404.201908164.

摘要

目的

从临床症状、应对方式、神经影像学3个方面比较抗抑郁药物联合(易术)心理剧和抗抑郁药物联合普通心理健康教育对伴童年创伤抑郁症患者的效果。

方法

在重庆医科大学附属第一医院精神科门诊收集伴童年创伤抑郁症患者，采用简单随机化分组的方法将其分为药物联合(易术)心理剧干预组(观察组，16例)与抗抑郁药物联合普通心理健康教育组(对照组，16例)进行前瞻性病例对照研究，两组患者均以选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitors

SSRIs)为主要抗抑郁药，服用6个月。以贝克抑郁自评量表(Beck depression inventor-13 item，BDI-13)、贝克焦虑自评量表(Beck anxiety inventor

BAI)、特质应对方式问卷(trait coping style questionnaire，TCSQ)及静息态功能磁共振(resting-state functional MRI

rs-fMRI)的自发低频振幅(amplitude of low frequency fluctuation

ALFF)为观察指标，比较干预结束后两组患者各指标的变化值差异。

结果

经过6个月的干预，两组患者之间的BDI、BAI变化值无明显差异，但是观察组TCSQ积极(

0.05)及TCSQ消极(

0.01)均较对照组改善更明显。rs-fMRI检查获得了19个交互作用脑区(经过

0.05的FDR校正)

事后检验发现，干预后观察组与对照组相比，观察组左内侧额上回激活增强趋势明显(

0.05)、右侧海马旁回(

0.01)激活增强较多，左侧楔前叶(

0.05)激活减弱较多。

结论

抗抑郁药物联合(易术)心理剧干预在改变伴童年创伤抑郁症患者的应对方式方面较联合普通心理健康教育效果可能更好，这可能与(易术)心理剧可以通过增强右侧海马旁回激活和减弱左侧楔前叶的激活，从而减弱负性经历对情绪和认知-应对的负面影响有关。(易术)心理剧可用于伴童年创伤抑郁症患者的药物联合治疗中。

Abstract

Objective

To compare the effects of the combination of (Yishu) psychodrama versus general mental health education with antidepressants on clinical symptoms

coping style and neuroimaging features in patients with major depressive disorder (MDD) who experienced childhood trauma.

Methods

This prospective case-control study was conducted in MDD patients with childhood trauma recruited from our department of psychiatry. The patients were randomly assigned into observation group (

=16) for treatment with antidepressants combined with (Yishu) psychodrama and control group (

=16) treated with antidepressants and general mental health education

and selective serotonin reuptake inhibitors (SSRIs) was used as the main antidepressants for 6 months in both groups. After the interventions

the patients were assessed using Beck Depression Inventory-13 item (BDI-13)

Beck Anxiety Inventory (BAI)

and Trait Coping Style Questionnaire (TCSQ)

and the amplitude of low frequency fluctuations (ALFF) in resting functional magnetic resonance imaging (fM

RI) was determined and compared between the two groups.

Results

After 6 months of intervention

no significant differences were found in the changes of BDI score (

0.05) or BAI score (

0.05) between the two groups

but the changes in TCSQ positive score (

0.05) and TCSQ negative score (

0.01) differed significantly between them. Resting fMRI results showed 19 interactive brain regions (corrected by FDR

0.05) in these patients. Post hoc analysis revealed that after the intervention

the patients in the observation group

as compared with the control patients

tended to have enhanced activation of the left medial superior frontal gyrus (

0.05) and showed significant enhancement of activation in the right parahippocampal gyrus (

0.01) with attenuated activation in the left precuneus lobe (

0.05).

Conclusion

Antidepressants combined with psychodrama can more effectively modify the coping style of depressed patients with childhood trauma than the combination of medications and general mental health education

possibly due to the effect of psychodrama to enhance the activation of the right parahippocampal gyrus and attenuate the activation of the left anterior cuneiform lobe

which leads to reduction of the adverse effects of negative experiences on emotion and cognition-coping. Psychodrama combined with medications can be used in the treatment of depressed patients with childhood trauma.

关键词

Keywords

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