神经症优化治疗方案的特尔菲法研究  

Optimization for the treatment of neurosis:A Delphi consensus study

作　　者：罗晓敏[1] 黄悦勤[1] 王向群[1] 刘肇瑞[1] 唐妮[1] 

机构地区：[1]北京大学精神卫生研究所卫生部精神卫生学重点实验室(北京大学),北京100191

出　　处：《中国心理卫生杂志》2011年第4期273-278,共6页Chinese Mental Health Journal

基　　金：国家科技支撑计划课题(2007BAI17B01)

摘　　要：目的:探讨不同类型神经症治疗的最优治疗方案。方法:采用文献法初步筛选出神经症已有明确疗效的全部药物和心理治疗方案,在此基础上采用专家咨询法(Delphi法),选择来自我国20家精神专科三级医院的20名精神科临床专家,进行两轮专家咨询,最终筛选出公认的神经症最优治疗方案。结果:神经症的最优治疗方案分别是强迫症为帕罗西汀联合认知行为治疗,社交焦虑障碍为帕罗西汀联合综合性心理治疗和帕罗西汀联合认知行为治疗,惊恐障碍为选择性5-羟色胺再摄取抑制剂(Selective Seroto-nin Reuptake Inhibitors,SSRI)类合并苯二氮卓艹类联合认知行为治疗和帕罗西汀联合认知行为治疗,广泛性焦虑障碍为帕罗西汀联合认知行为治疗和SSRI类合并苯二氮卓艹类联合认知行为治疗。结论:专家咨询法成功筛选出了强迫症、社交焦虑障碍、惊恐障碍和广泛性焦虑障碍四类神经症的最优治疗方案。Objective： To explore the optimal therapies of different types of neurosis. Methods： Literature method was used for screening all the effective medical and psychological treatment for neurosis, then the Delphi method was used and 20 psychiatric specialists from 20 third-level psychiatric hospitals were selected to take part in the two rounds of expert consultation, at last the optimal therapies of different types of neurosis were selected. Results： The optimal treatment of neurosis were as follows： obsessive-compulsive disorder was paroxetine plus cognitive behavior therapy, social anxiety disorder was paroxetine plus comprehensive psychological therapy and paroxetine plus cognitive behavior therapy, panic disorder was for the SSRI （ selective serotonin reuptake inhibitors） and benzodiazepine plus cognitive behavioral therapy and paroxetine plus cognitive behavior therapy, generalized anxiety disorder was paroxetine plus cognitive behavior therapy and paroxetine plus cognitive behavior therapy. Conclusion： The optimal therapies of four types of neurosis, including obsessive-compulsive disorder, social anxiety disorder, panic disorder, and generalized anxiety disorder, are successfully selected by using the Delphi study.

关 键 词：神经症 强迫症 社交焦虑障碍 惊恐障碍 广泛性焦虑障碍 专家咨询法 Delphi研究 

分 类 号：R749.705.3[医药卫生—神经病学与精神病学]