家庭治疗联合药物治疗对首发青少年抑郁症的效果  

Effect of family therapy combined with antidepressants on the first-onset adolescent depression

作　　者：谢艳红 李映娟 王相兰[2] 吴娟 叶丽 李勇 

机构地区：[1]兴宁市人民医院心理科,广东兴宁514500 [2]中山大学附属第三医院精神科,广东广州510630

出　　处：《新乡医学院学报》2015年第6期543-545,548,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨家庭治疗联合药物治疗对首发青少年抑郁症的效果。方法将78例首次发作未经治疗的青少年抑郁患者随机分为单一抗抑郁药物治疗的对照组和抗抑郁药物治疗联合家庭治疗的观察组,每组39例。根据患者病情综合判断后,对所有患者个体化选择抗抑郁药并规范治疗,观察组患者在药物治疗的基础上联合应用家庭治疗。以汉密尔顿抑郁量表(HAMD)总分减分率作为疗效评估指标,应用家庭环境量表评估2组患者的家庭特征,比较2组患者的治疗效果。结果 24周治疗完成时,观察组患者治疗总有效率显著高于对照组(P<0.01),随访结束时观察组患者复发率显著低于对照组(P<0.01)。治疗前2组患者HAMD评分比较差异无统计学意义(P>0.05)。治疗第4周起,观察组患者HAMD评分显著低于对照组(P<0.05,P<0.01)。治疗完成后,观察组患者情感表达、组织性及独立性、娱乐性、道德宗教观等方面的评分显著高于对照组(P<0.05,P<0.01)。结论家庭治疗联合药物治疗可提高青少年抑郁症的治疗效果,改善家庭环境和教养方式对预防其复发具有重要作用。Objective To study the effect of the family therapy combined with antidepressants on the first-onset adolescent depression. Methods Seventy-eight first-onset and drug-negtive patients with adolescent depression were selected and randomly divided into control group with antidepressants therapy only and study group with family therapy combined with antidepressants,with 39 cases in each group. The individualized regular antidepressants therapy was applied to the patients in both two groups according to each patient＇s condition,and family therapy was performed for patients only in the study group. The reduction rate of the Hamilton depression scale（ HAMD） scores after treatment was compared with the scores before treatment to assess the therapy effect. The Chinese version of the family environment scale（ FES-CV） was used to evaluate the family characteristics of participants in both groups after treatments. Results At the end of the 24-week treatment,the total effective rate of the study group was significantly higher than that of the control group（ P〈0. 01）. At the end of the follow-up,the relapse rate of the study group was significantly lower than that of the control group（ P〈0. 01）. There was no significant difference of the HAMD scores between the study group and control group before treatment（ P〉0. 05）,and HAMD scores of study group was significant lower than that of controls from the fourth week to the end of the treatment（ P〈0. 05,P〈0. 01）. Twenty-four weeks after treatment,factor scores of FES-CV including expressiveness,organization,independence,active-recreational orientation and moral-religious emphasis of the study group were significantly higher than those of the control group（ P〈0. 05,P〈0. 01）. Conclusion The strategy of combining family therapy with antidepressants can increase the clinical recovery rate of the adolescent depression,and improvement of the family environment and parenting style may be important for decreasing the relapse rate of adolescent de

关 键 词：家庭治疗 青少年抑郁症 复发 

分 类 号：R749.4[医药卫生—神经病学与精神病学]