成人注意缺陷多动障碍认知行为治疗疗效相关因素  

Related factors of cognitive behavior therapy for adults with attention-deficit/hyperactivity disorder

作　　者：赵梦婕 黄芳[1] 王延菲 王玉凤[1] 钱秋谨[1] 

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,国家精神心理疾病临床医学研究中心(北京大学第六医院),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》2017年第12期941-947,共7页Chinese Mental Health Journal

基　　金：国家科技支撑计划项目(2015BAI13B01);国家重点基础研究发展计划(973计划)(2014CB846104);首都卫生发展科研专项项目(首发2016-2-4113);北京市科学技术委员会"首都临床特色应用研究"专项基金(Z131107002213068)

摘　　要：目的:初步探讨成人注意缺陷多动障碍(ADHD)的认知行为治疗(CBT)疗效相关因素。方法:采用前瞻性开放性、自身对照设计,选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)成人ADHD诊断标准的门诊患者85例,进行12周认知行为治疗,使用ADHD评定量表(ADHD-RS)评估ADHD核心症状,根据治疗后ADHD量表减分率≥25%分为治疗有效组(n=41例),减分率<25%分为治疗无效组(n=44例),采用t检验/χ~2检验比较治疗有效组及治疗无效组在人口统计学、疾病特征及早期疗效(治疗第4周ADHD量表减分率≥25%为早期起效)方面的差异,采用logistic回归分析CBT疗效相关因素。结果:在治疗有效组中,早期起效者比治疗无效组更多(P<0.05)。Logistic回归分析显示,BIS运动冲动分数较高(OR=1.27)、早期起效(OR=11.87)的患者CBT更易起效。结论:运动冲动症状越重、早期起效的成人ADHD患者CBT疗效较好。Objective： To explore the related factors to the effect of cognitive behavior therapy （CBdults with attention-deficit/hyperactivity disorder（ ADHD）. Methods： A prospective and open-label, self-control study was designed. Eighty-five adult patients from outpatient department with ADHD diagnosed with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition（DSM-IV）. All the patients received 12 weeks of CBT, the ADHD Rating Scale （ADHD-RS） was used to evaluate ADHD core symptoms, and according to the post-treat ADHD-RS reduction ratio, 41 patients were divided into responders （ADHD-RS reduction ratio ≥25 %） tients were divided into non-responners（ ADHD-RS reduction ratio 〈25% ） The t-test and chi-square test were used to analyze the differences of sociodemographic variables, clinical variables and early efficacy ratio ≥ 25 % in the fourth week） between the two groups, and logistics regression was used to factors. Results： Comparing with the group of non-responders, there was more cases within the group of responders. Logistic models indicated that higher scores of BIS-motor （OR=1.27）,early efficacy（OR = 11. 8 7） were associated with better CBT efficacy . Conclusion： It suggests motor impulsiveness symptom, and early efficacy may get favorableresponse to CBT.

关 键 词：成人 注意缺陷多动障碍 认知行为治疗 早期起效 Barratt冲动量表 

分 类 号：R749.99[医药卫生—神经病学与精神病学]