مقايسه اثر بخشي درمان شناختي- رفتاري و درمان مبتني بر پذيرش و تعهد برافسردگي و علائم مثبت و منفي در بيماران اختلال دو قطبي

Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy on Depression and Positive and Negative Symptoms in Patients with Bipolar Disorder

ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﻣﻘﺎﯾﺴﻪ اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﺷﻨﺎﺧﺘﯽ- رﻓﺘﺎري و درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ اﻓﺴﺮدﮔﯽ و ﻋﻼﺋﻢ ﻣﺜﺒﺖ و ﻣﻨﻔﯽ ﺑﯿﻤﺎران اﺧﺘﻼل دو ﻗﻄﺒﯽ اﻧﺠﺎم ﭘﺬﯾﺮﻓﺖ. در اﯾﻦ ﭘﮋوﻫﺶ آزﻣﺎﯾﺸﯽ، ﮐﻪ ﺑﺎ اﺳﺘﻔﺎده از روش ﻧﻤﻮﻧﻪ ﮔﯿﺮي در دﺳﺘﺮس ﺑﻪ ﺻﻮرت ﭘﯿﺶ آزﻣﻮن- ﭘﺲ آزﻣﻮن ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل اﻧﺠﺎم ﮔﺮﻓﺖ، 36 ﻧﻔﺮ از ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪﮔﺎن ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎﻧﻬﺎي اﻋﺼﺎب و روان، ﮐﻪ ﺑﺮ اﺳﺎس ﻣﻼك ﻫﺎي راﻫﻨﻤﺎي ﺗﺸﺨﯿﺼﯽ و آﻣﺎري اﺧﺘﻼﻻت رواﻧﯽ، ﺗﺸﺨﯿﺺ اﺧﺘﻼل دو ﻗﻄﺒﯽ درﯾﺎﻓﺖ ﻣﯽ ﮐﺮدﻧﺪ ﺑﻪ ﻃﻮر ﺗﺼﺎدﻓﯽ ﺑﻪ ﺳﻪ ﮔﺮوه 12 ﻧﻔﺮي ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. ﮔﺮوه اول ﺗﺤﺖ 10 ﺟﻠﺴﻪ درﻣﺎن ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري، ﮔﺮوه دوم ﺗﺤﺖ 12 ﺟﻠﺴﻪ درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ و ﮔﺮوه ﮐﻨﺘﺮل ﻫﯿﭻ ﻣﺪاﺧﻠﻪ اي درﯾﺎﻓﺖ ﻧﮑﺮدﻧﺪ و در ﻟﯿﺴﺖ اﻧﺘﻈﺎر ﻗﺮار ﮔﺮﻓﺘﻨﺪ. داده ﻫﺎ از ﻃﺮﯾﻖ ﭘﺮﺳﺸﻨﺎﻣﻪ ﻫﺎي اﻓﺴﺮدﮔﯽ دوﻗﻄﺒﯽ و ﻣﻘﯿﺎس ﻋﻼﺋﻢ ﻣﺜﺒﺖ و ﻣﻨﻔﯽ اﺳﮑﯿﺰوﻓﺮﻧﯽ ﺟﻤﻊ آوري ﮔﺮدﯾﺪ. ﺑﺮاي ﺗﺤﻠﯿﻞ داده ﻫﺎ از ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ اﺳﺘﻔﺎده ﺷﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ ﻧﺸﺎن داد درﻣﺎن ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري و درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ در ﮔﺮوﻫﻬﺎي آزﻣﺎﯾﺶ ﺑﺎﻋﺚ ﮐﺎﻫﺶ اﻓﺴﺮدﮔﯽ و ﻋﻼﺋﻢ ﻣﺜﺒﺖ و ﻣﻨﻔﯽ ﺷﺪه اﺳﺖ. در ﺣﺎﻟﯿﮑﻪ در ﮔﺮوه ﮐﻨﺘﺮل ﭼﻨﯿﻦ ﺗﻐﯿﯿﺮي ﻣﺸﺎﻫﺪه ﻧﺸﺪ. ﻫﻤﭽﻨﯿﻦ ﺑﯿﻦ درﻣﺎن ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري و درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ در ﮐﺎﻫﺶ اﻓﺴﺮدﮔﯽ، اﺧﺘﻼف ﻣﻌﻨﺎداري ﻣﺸﺎﻫﺪه ﻧﺸﺪ. اﻣﺎ روﯾﮑﺮد اﮐﺖ، ﺑﺮ ﺗﻨﻈﯿﻢ ﻋﻼﺋﻢ ﻣﺜﺒﺖ و ﻣﻨﻔﯽ اﺛﺮﺑﺨﺸﯽ ﺑﯿﺸﺘﺮي داﺷﺘﻪ اﺳﺖ. ﺑﻨﺎﺑﺮ ﻧﺘﺎﯾﺞ اﯾﻦ درﻣﺎﻧﻬﺎ در ﮐﺎﻫﺶ ﻋﻼﺋﻢ اﺧﺘﻼل دوﻗﻄﺒﯽ اﺛﺮ ﺑﺨﺸﻨﺪ. ﻟﺬا ﺗﺪوﯾﻦ اﯾﻦ ﻣﺪاﺧﻼت درﻣﺎﻧﯽ در ﮐﻨﺎر دارو درﻣﺎﻧﯽ ﻣﯽ ﺗﻮاﻧﺪ ﺳﺒﺐ ﮐﻨﺘﺮل و ﺟﻠﻮﮔﯿﺮي از ﻋﻮد ﻋﻼﺋﻢ اﺧﺘﻼل دوقطبي شود

The purpose of this study was to compare the effectiveness of cognitive-behavioral therapy and admission-and-acceptance therapy on depression and positive and negative symptoms of bipolar disorder patients. In this quasi-experimental study, 36 pre-test and post-test posttest students were randomly selected using available sampling method and 36 psychiatric hospitals referring to diagnostic and statistical guidelines for psychiatric disorders , Diagnosed with bipolar disorder, were randomly divided into three groups of 12. The first group received 10 sessions of cognitive-behavioral therapy, the second group received no intervention during 12 sessions of acceptance and commitment therapy, and the control group received no intervention and were placed on the waiting list. Data were collected through questionnaires of bipolar depression and positive and negative symptoms of schizophrenia. For data analysis, covariance analysis was used. The findings showed that cognitive-behavioral therapy and admission and commitment therapy in the experimental groups reduced depression and positive and negative symptoms. While no change was observed in the control group. There was also no significant difference between cognitive-behavioral therapy and acceptance-based treatment and commitment to reduce depression. But the ACT approach has been more effective in regulating both positive and negative symptoms. The results of these treatments will reduce the symptoms of bipolar disorder. Therefore, the development of these therapeutic interventions along with drug therapy can control and prevent recurrence of symptoms of bipolar disorder. Keywords: Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, Bipolar Disorder, Positive and Negative Symptoms, Depression