认知行为治疗联合氟西汀治疗拒绝上学的临床研究  

A Research on the Cognitive Behavioral Therapy for School Refusal

作　　者：刘芳[1] 吴歆[2] 朱澜[2] 施穗琴[2] 

机构地区：[1]解放军白求恩国际和平医院,石家庄050082 [2]广西壮族自治区人民医院,南宁530021

出　　处：《临床误诊误治》2007年第7期4-6,共3页Clinical Misdiagnosis & Mistherapy

基　　金：北京军区"十一五"计划课题;NO.06BJ032

摘　　要：目的：探讨认知行为治疗（cognitive behavioral therapy,CBT）及氟西汀治疗拒绝上学（school refusal,SR）的疗效.方法：选择2005年7月～2007年3月符合SR诊断标准者75例,随机分为CBT组（n=36）、CBT＋氟西汀组（n=39）,疗程24周,治疗前后采用焦虑自评量表（SAS）、抑郁自评量表（SDS）、临床全面印象量表（CGI-S）和返校率进行评估.结果：CBT组治疗前后SAS、SDS、CGI-S评分比较有统计学差异（P＜0.01）,返校率72.22%;CBT＋氟西汀组治疗前后SAS、SDS、CGI-S评分比较有统计学差异（P＜0.01）,返校率82.05%.两组间返校率比较无统计学差异（P＞0.05）.结论：CBT和CBT联合氟西汀均可以有效治疗SR,以联合治疗效果可能最佳.Objective：To study and evaluate the effect of the cognitive behavioral therapy（CBT） for School Refusal（SR）. Methods：75 patients who met the criteria were randomized into two groups：the cognitive behaviour therapy （CBT） alone （n = 36） ; CBT plus Fluoxetine （n = 39）, the treatment period was 24 weeks. The Self-Rating Anxiety Scale （SAS）, the Self-Rating Depression Scale,the Clinical Global Impression -Severity scale （CGI-S） and the percentage of school attendance were conducted before and after treatment. Results：After 24 weeks,in the CBT alone group,the SAS score, SDS score and CGI-S score were significantly decreased IP 〈 0.01 ,and the percentage of school attendance was 72.22% ;In the CBT plus Fluoxetine group,the SAS score,SDS score and CGI-S score were significantly decreased, P 〈 0.01, and the percentage of school attendance was 82.05%. There was not significantly difference in the percentage of school attendance between the two groups, P 〉 0.05. Conclusion ：The CBT alone and CBT plus Fluoxetine can effectively treat SR,and the combined therapy may be the best one.

关 键 词：精神障碍 拒绝上学 认知行为治疗 氟西汀 

分 类 号：R749.94[医药卫生—神经病学与精神病学]