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

摘要： 背景　抑郁症患者常因强烈的病耻感、较低的治疗依从性导致疾病得不到有效控制，甚至加重抑郁的症状，因此，在治疗抑郁症的同时需开展降低患者病耻感、提高治疗依从性的心理治疗。目的　观察知行分析疗法（PBAT）对抑郁症（MDD）患者的治疗依从性、病耻感以及抑郁症状的影响。方法　选择2017年1月—2018年1月于扬州大学附属苏北人民医院临床心理科门诊治疗的MDD患者75例为研究对象。采用随机数字表法将患者分为研究组38例和对照组37例。两组患者均给予选择性5-羟色胺再摄取抑制剂（SSRIs）西酞普兰治疗，此外，对照组予常规心理健康教育，研究组给予PBAT（根据治疗设置，共需8次，50 min/次）。收集患者一般资料，分别于治疗前及治疗后（治疗8周时）采用Morisky治疗依从性问卷（MMAS-8）评估患者治疗依从性，病耻感自我评估量表（SS）评估患者的病耻感，汉密尔顿抑郁量表（HAMD）-24评估患者抑郁症状及治疗效果。结果　研究组治疗后MMAS-8得分高于对照组（P<0.05）；研究组治疗后MMAS-8得分高于治疗前（P<0.05）。研究组治疗后治疗依从性优于对照组（P<0.05）；对照组、研究组治疗后治疗依从性均优于本组治疗前（P<0.05）。研究组治疗后社交、能力、治疗维度得分及SS总分低于对照组（P<0.05）；研究组治疗后社交、能力、治疗维度得分及SS总分低于治疗前（P<0.05）。研究组治疗后HAMD-24得分低于对照组（P<0.05）；对照组、研究组治疗后HMAD-24得分均低于本组治疗前（P<0.05）。研究组治疗效果优于对照组（P<0.05）。结论　PBAT可有效增加MDD患者的治疗依从性，降低其病耻感，减少抑郁症状，提升治疗效果。

关键词: 抑郁症, 病人依从, 病耻感, 知行分析疗法