不同治疗方法对儿童青少年拒绝上学的疗效观察  

Impact of Different Treatment Methods of School Refusal Among Adolescents

作　　者：吴歆[1] 刘芳[2] 朱澜[1] 施穗琴[1] 

机构地区：[1]广西壮族自治区人民医院心理康复中心,南宁530021 [2]石家庄市白求恩国际和平医院儿科

出　　处：《中国学校卫生》2007年第6期519-520,共2页Chinese Journal of School Health

基　　金："十一五"北京军区课题项目

摘　　要：目的探讨拒绝上学(School Refusal,SR)的不同治疗方法,并比较各自的疗效,为采取相应的干预措施提供依据。方法将52例SR患者随机分为3个治疗组,其中单独认知行为治疗(CBT)组16人,氟西汀治疗组18人,CBT+氟西汀治疗组18人,疗程24周。治疗前、后采用焦虑自评量表(SAS)、临床全面印象量表(CGI-S)和返校率进行评估。结果单独CBT治疗组治疗前后SAS、CGI-S评分比较,差异均有统计学意义(P值均<0.01),返校率为75.00%;单独氟西汀治疗组治疗前后SAS、CGI-S评分比较,差异均有统计学意义(P值均<0.01),返校率为72.22%;CBT+氟西汀治疗组治疗前后SAS、CGI-S评分比较,差异均有统计学意义(P值均<0.01),返校率为83.30%。各组间返校率比较,差异无统计学意义(P>0.05)。结论CBT、氟西汀及两者联合治疗均可以有效治疗SR,联合治疗疗效可能最佳。Objective To evaluate the impact of different treatment in school refusal（SR）, and to provide evidence for the intervention measures. Methods Fifty-two patients with SR were randomized into three groups： cognitive behavior therapy （CBT） alone （ n=16 ） ; Fluoxetine alone （ n = 18 ） ; CBT＋ Fluoxetine （n=18）. The treatment lasted for 24 weeks. Self-Rating Anxiety Scale （SAS）, Clinical Global Impression-severity Scale （CGI- S） and the school attendance were conducted before and after the treatment. Results After 24 weeks, in the CBT alone group, the SAS score and CGI - S score were significantly decreased（ P 〈 0.01 ）, and the percentage of school attendance was 75.00% ; in Fluoxetine alone group, the SAS score and CGI - S score were significantly decreased （ P 〈 0.01 ）, and the percentage of school attendance was 72.22% ; in the combined therapy group, the SAS score and CGI - S score were significantly decreased（P 〈 0.01 ）, and the percentage of school attendance was 83.30%. There was no significant difference in the percentage of school attendance among the three groups（ P 〉 0.05 ）. Conclusion The CBT alone, Fluoxetine alone and combined therapy can effectively treat SR, and the combined therapy may be the best one.

关 键 词：学习 拒绝(心理学) 治疗结果 精神卫生 青少年 

分 类 号：R179[医药卫生—妇幼卫生保健] R395.6[医药卫生—公共卫生与预防医学]