The Influence Of Yi Shu Psychodrama Combined With Antidepressants On Well-being And Depression And Anxiety In Patients With Childhood Traumatic Depression

Background: Major Depressive Disorder(MDD)was a common mental and psychological disease with high recurrence and high persistence.It was mainly manifested by symptoms such as persistent depression,decreased interest,impaired cognitive function,and poor motivation.Childhood abuse was an important risk factor for the onset of depression,and it was also an important cause of repeated depression and chronic refractory treatment.Often medication alone,or even physical therapy such as electroconvulsive therapy to treat childhood traumatic depression was not effective.According to research,approximately 50%of MDD patients had childhood traumatic experiences,which seriously affected the development of individual positive psychological resources and reduced the general well-being in adulthood.General well-being was a comprehensive psychological indicator for assessing an individual's quality of life.Compared with the normal population,MDD patients tended to have lower levels of well-being.As the country payed more and more attention to the well-being of the people,how to effectively help MDD patients with childhood trauma to improve their emotions and their well-being in life was of great significance.For the treatment of MDDpatients,many studies had clearly identified the effect of antidepressants combined with psychotherapy was better than that of antidepressants alone.It had been clinically shown that psychodrama was effective for psychological trauma,but there were few studies on the treatment of depression by psychodrama.The Yi Shu psychodrama,as a localized psychotherapy based on the classic psychodrama combined with oriental philosophy,Chinese culture and Chinese medicine psychology,was less studied.Therefore,this study used Yi Shu psychodrama combined with first-line antidepressants to treat depression patients with childhood trauma.The antidepressants were mainly Selective Serotonin Reuptake Inhibitors(SSRIs)or Serotonin And Norepinephrine Reuptake Inhibitors(SNRIs).And a randomized controlled study between it and general health education combined with first-line antidepressants was conducted,in order to provide a basis for the development of reasonable treatment plans for MDD patients with childhood trauma.Objectives: 1.To explore the correlation of childhood trauma with general well-being and depression and anxiety in MDD patients with childhood trauma.2.To explore the clinical benefits of Yi Shu psychodrama combined with first-line antidepressants on MDD patients with childhood trauma,and provide reference for clinicians to formulate a reasonable treatment plan in the future.Methods: 1.Use childhood experience interviews and Childhood Trauma Questionnaire(CTQ)to evaluate psychiatric patients with depression.General Well-being Schedule(GWB),Beck Depression Inventory(BDI)and Beck Anxiety Inventory(BAI)were evaluated for patients with positive childhood trauma,and the results were statistically analyzed.2.According to the inclusion and exclusion criteria,33 people in the observation group and 27 people in the control group were enrolled,and both groups were treated with SSRIs or SNRIs antidepressants.The observation group received Yi Shu psychodrama treatment in batches in addition to antidepressants,once every 3 months for 4 consecutive days,3times in total,and the observation was continued for 6 months.The control group received general health education in addition to antidepressants.General Well-being Schedule(GWB),Beck Depression Inventory(BDI)and The Beck Anxiety Inventory(BAI)were used to evaluate at baseline and at 6 months,and the results were statistically analyzed.Results: 1.Correlation analysis shows that GWB was significantly negatively correlated with emotional abuse and emotional neglect(r =-0.26,-0.20,p <0.01);BDI was significantly positively correlated with emotional abuse,emotional neglect and physical abuse(r= 0.39,0.30,0.21,p <0.01);there was a positive correlation between anxiety and emotional abuse(r = 0.20,p <0.05).At the same time,GWB was significantly negatively correlated with BDI and BAI(r =-0.68,-0.60,p <0.01).2.There was no significant difference in the general demographic characteristics,GWB and its dimensions,BDI and BAI between the observation group and the control group before the intervention(all p >0.05).3.Repeated measures analysis of variance after intervention showed that,there were statistical significance on the total scores of GWB and the dimensions of worry about health,energy,satisfaction and interest to life in GWB between measure time and group intervention(all p <0.05).The interaction between time and intervention on BAI and BAI was not statistically significant(all p > 0.05).4.The simple effect showed that the total scores and scores in all dimensions of the observation group in GWB after the intervention were significantly increased compared with those before intervention(all p <0.01).In the control group,the total scores andthe scores in dimensions of satisfaction and interest to life,depression or happy mood,relax and nerves,emotion and behavior control in GWB were significantly increased compared with those before intervention(all p <0.05).However,compared with the control group,the observation group improved more significantly in GWB's total score,worry about health,energy,satisfaction and interest to life(all p <0.05).The BDI and BAI scores of the two groups of patients were lower after intervention,and the BDI reduction of the observation group was better than the control group(p <0.05).Conclusions: 1.The more obvious emotional abuse and emotional neglect encountered by MDD patients with childhood trauma,the worse their level of general well-being and the more obvious they were in depression and anxiety.Therefore,alleviating the impact of childhood trauma,especially emotional abuse and emotional neglect on individuals was of great significance to improving the individual's depression,anxiety and well-being.2.Compared with general health education combined with antidepressants,Yi Shu psychodrama combined with antidepressants could more effectively improve depression and general well-being in MDD patients with childhood trauma.Yi Shu psychodrama played its own unique role in dealing with childhood trauma,negative emotions and improving life well-being of MDD patients.Yi Shu psychodrama had clinical application value.