| Background: Major Depressive Disorder is one of the most common mental disorders.It is a general term for a class of diseases whose main manifestation is low mood,accompanied by varying degrees of cognitive and behavioral changes.Some patients have self-harm,suicidal behavior,and even death as a result.People spend about 1/3 of their life sleeping.Major Depressive Disorder patients often have sleep disorders,and sleep disorders are often the first symptom of Major Depressive Disorder patients.It can increase the severity of Major Depressive Disorder and affect their prognosis and quality of life.Difficulty falling asleep,early awakening,increased awakening or excessive sleep are common symptoms of Major Depressive Disorder.The two influence each other and eventually form a vicious circle.For the treatment of symptoms and sleep disorders in patients with Major Depressive Disorder,drug treatment is commonly used in clinical practice,but patients often stop the drug due to drug side effects,and the treatment compliance is poor,which often leads to recurrence of the disease.Early clinical observation of Yi Shu psychodrama group therapy found that it can improve the sleep quality of patients with Major Depressive Disorder.However,research on Yi Shu psychodrama intervention in patients with Major Depressive Disorder is still rare,so this study uses Yi Shu psychodrama to treat Major Depressive Disorder,and A controlled study of drug therapy alone aims to provide more alternative treatment options for the improvement of sleep in patients with Major Depressive Disorder.Objective: To explore the improvement of sleep quality of patients with Major Depressive Disorder by Yi Shu psychodrama therapy,and to provide more options for clinical treatment.Methods: According to the enrollment and exclusion criteria,45 patients with mild to moderate Major Depressive Disorder who attended the psychiatric clinic of the First Affiliated Hospital of Chongqing Medical University were randomly divided into observation group(n=22)and control group(n=23).The observation group was given Yi Shu psychodrama treatment,and the control group was given first-line antidepressant(escitalopram oxalate)treatment.The Beck Anxiety Inventory(BAI)and Beck Major Depressive Disorder were performed before the intervention and at the end of the 2 months.The Pittsburgh Sleep Index Questionnaire(PSQI)and Polysomnography(PSG)were evaluated by BDI,Pittsburgh Sleep Index Questionnaire(PSQI),and polysomnography(PSG),and the questionnaire and sleep breathing monitoring data were sorted and analyzed statistically.Results:1.Before intervention,there were no significant differences in general demographic characteristics,type of hypnotic,Baker Depression index(BDI),Baker Anxiety index(BAI),Pittsburgh sleep index questionnaire(PSQI)and sleep breathing monitoring(PSG)between the study group(Yi Shu psychological drama group)and the control group(antidepressant group)(all P > 0.05).2.Repeated measurement analysis of variance of the two groups of patient monitoring indicators found that the total PSQI score and the time to fall asleep,hypnotic drugs,daytime function and other dimensions of the interaction effect of the intervention were statistically significant(F=4.806,6.506,6.292,8.708,P<0.05);The total sleep time,wake time after sleep in BDI,BAI,PSG,and the interaction effects of time and intervention methods in the dimensions of sleep quality,sleep time,sleep efficiency,sleep disorder in PSQI,etc.are not statistically available Academic significance(F=0.015,0.030,2.449,0.854,1.781,0.932,1.705,0.674,all P>0.05).BDI,BAI,PSG total sleep time,PSQI total score and its sleep quality,time to fall asleep,sleep time,sleep disturbance,daytime function and other dimensions have statistical significance in the time effect(F=148.765,61.663,7.461,20.205,21.588,25.948,6.009,13.777,23.097,all P<0.05);the sleep efficiency and hypnotics dimensions in PSQI had no statistical significance in the main effect of time(F=0.014,0.945,all P>0.05).The awake time after sleep,the total PSQI score and its sleep quality,time to fall asleep,and hypnotic drugs in PSG are statistically significant in the intervention effect(F=4.169,6.671,6.248,11.251,6.960,all P<0.05).The total sleep time in BDI,BAI,PSG and the dimensions of sleep time,sleep efficiency,sleep disorder,and daytime function in PSQI are not statistically significant in the intervention effect(F=0.605,0.494,2.226,0.421,3.526,0.121,2.598,P>0.05).3.A simple effect analysis showed that before the intervention,the two groups of patients had no statistically significant differences in total sleep time,wake time after sleep,total PSQI score and their scores in each dimension in BDI,BAI,and PSG(F=0.328,0.132,3.887,1.158,1.055,1.338,1.076,0.007,0.862,0.014,0.456,0.256,all P>0.05).Comparison within the group after the intervention showed that the total sleep time in BDI,BAI,PSG,PSQI total score and sleep quality,time to fall asleep,sleep time,sleep disorders,hypnotics,and daytime function scores in the observation group were all lower than before the intervention,The difference was statistically significant(F=74.233,31.517,9.028,21.874,17.495,28.584,5.711,10.050,5.925,29.431,all P<0.05),while PSG’s wake-up time after sleep and PSQI’s sleep efficiency dimension score There was no change compared with the previous,and the difference was not statistically significant(F=1.153,0.692,P>0.05);the control group’s BDI,BAI total scores and PSQI sleep quality and sleep disorder dimension scores decreased compared with the previous,and the difference was statistically significant(F=74.555,30.147,5.609,4.272,P<0.05),while the total sleep time,wake-up time after sleep,PSQI total score and other scores in PSG did not change compared with before,and the difference was not statistically significant(F=0.696,0.050,2.712,3.308,1.129,1.034,1.207,1.759,all P>0.05).The comparison between groups showed that the awake time after sleep,PSQI total score and sleep quality,time to fall asleep,sleep efficiency,hypnotics,and day function scores in the observation group were lower than those in the control group,and the difference was statistically significant(F=5.709,14.324,10.158,11.485,6.314,13.658,8.873,P<0.05),while the observation group had no total sleep time in BDI,BAI,PSG,sleep time in PSQI,and sleep disorder dimension score compared with the control group.The difference was not statistically significant(F=0.386,0.765,0.117,1.101,0.830,all P>0.05).Conclusion: Yi Shu psychodrama is as effective as antidepressants in improving the anxiety and Major Depressive Disorder of patients with mild to moderate Major Depressive Disorder,and it is better in improving the quality of sleep,and avoids daytime dysfunction caused by drug-induced adverse reactions,which is Major Depressive Disorder Non-pharmacological treatments provide more options. |
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