以團體方式進行之肌肉放鬆併生理迴饋對門診精神官能症病患之治療

目的：本研究在探討藉由生理迴饋戒指以團體方式進行肌肉放鬆併生理迴饋治療之可能性。方法：所有病人由精神科門診轉介至放鬆特別門診。在治療開始，病人完成自填量表，包括修訂版症狀量表-90（SCL-90R），及莫斯里人格量表（Maudsley Personality Inventory）。在完成六個小時的治療課程之後，病人再填寫一份治療後的修訂版症狀量表-90（SCL-90R）和有關療效的問卷調查。本研究共有二種治療模式：A組為每週一次一小時的團體治療課程時間且總共六次；B組為每週一次一個半小時的團體治療課程時間且總共四次。結果：共有180位病人曾被轉介至放鬆特別門診，男性76位，女性104位；A組127位，B組53位，且大部份為精神官能症病人，其中恐慌症有21位，精神官能性憂鬱症有58位，泛焦慮症有57位，不特定之焦慮症有14位。160位有填寫治療前之自填量表（A組113/127，B組47/53），其中88位（A組49/113，B組39/47）完成治療療程並填完治療後的所有自填量表。88位完成治療者在症狀量表-90的總分及個別項目上都有明顯的改善，與診斷沒有明顯的相關性。所有病人莫斯里人格量表和非精神科人口的一般常模比有明顯的差異，但A組、B組間沒有明顯差異。完成治療後問卷顯示，年紀愈輕愈能接受團體治療。結論：以團體方式進行之肌肉放鬆併生理迴饋對精神官能症病患是一種有效且經濟的治療方法。

Objective: The purpose of this study is to explore the possibility of performing muscle relaxation with biofeedback in group with the help of temperature biofeedback ring. Methods: Outpatients were referred from psychiatric OPD to relaxation special clinic. In the beginning of the treatment, patients finished self-rating scales including Symptom Check List-90 Revised (SCL-90R), and Maudsley Personality Inventory (MPI). After completing the 6-hour program, patients finished another post-treatment SCL-90R and a questionnaire of interval scale about ranking the effectiveness of the treatment. There were two kinds of group format: group A with weekly 1-hour session for 6 times and group B with weekly 1.5-hour session for 4 times. Results: There were 180 clients (male=76, female=104; 127 in group A, 53 in group B) once attending the special clinic, and most were neurotic patients (panic disorder=21, dysthymic disorder=58, generalized anxiety disorder= 57, anxiety NOS=14). 160 patients completed the pre-treatment self-rating scales (113/127 in group A and 47/53 in group B). 88 patients completed the whole treatment and all pre- and post-treatment scales (49/113 in group A and 39/47 in group B). The 88 patients showed significant improvement in total score and in respective items of SCL-90R, but there was no significant between-diagnoses effect. MPI score of all 160 patients showed significant difference when compared with non-psychiatric norm (P≒0), but there was no between-group difference about MPI scores. Correlation of post-treatment questionnaire showed more appreciation of group therapy for younger age. Conclusions: group-formed muscle relaxation with biofeedback is an effective and economical mode for treating neurotic patients.