舍曲林和辩证行为疗法治疗青少年抑郁障碍伴非自杀性自伤行为效果初探  

Effect of Dialectical Behavior Therapy and Sertraline on Adolescents with Depressive Disorder and Non-suicidal Self-injury Behavior

作　　者：汪晓静 汤义平[2] 许瑞智[2] 陈倩倩 许毅[3] WANG Xiao-jing;TANG Yi-ping;XU Rui-zhi;CHEN Qian-qian;XU Yi(School of Medicine,Zhejiang University,Hangzhou 310000,China;Taizhou Second People's Hospital,Taizhou 317200,China;The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院,杭州310000 [2]台州市第二人民医院心身科,台州317200 [3]浙江大学第一附属医院,杭州310000

出　　处：《中国临床心理学杂志》2024年第1期234-237,197,共5页Chinese Journal of Clinical Psychology

基　　金：浙江省卫生健康科技计划(伴非自杀性自伤行为的青少年抑郁症患者的辩证行为疗法研究,2021KY1213);(短程辩证行为治疗对自伤行为住院青少年的疗效及情绪反应性调节作用的研究,2022KY438)。

摘　　要：目的:探索使用舍曲林和辩证行为疗法干预伴非自杀性自伤行为的青少年抑郁患者的有效性。方法:选取90例在我院心身科门诊就诊的伴有非自杀性自伤行为的青少年抑郁症患者,按随机数字表法平均分为舍曲林组、辩证行为组以及联合组。分别于不同时间点应用HAMD-17以及HAMA评定患者抑郁、焦虑水平;通过渥太华自伤问卷(OSI)和特质应对方式问卷(TCSQ)评定患者自伤及应对状况。结果:联合组HAMD-17、HAMA以及TCSQ的消极应对因子得分在治疗第12周较舍曲林组、辩证行为组低,TCSQ的积极应对因子得分更高,且自伤次数下降较另外两组更明显。结论:舍曲林联合辩证行为疗法在提高青少年积极应对能力方面更为有效。Objective:To compare the efficacy between dialectical behavior therapy combined with sertraline and sertraline alone or dialectical treatment alone in adolescents with depressive disorder and non-suicidal self-injury behavior.Methods:90 adolescent depression patients with non-suicidal self-injury were recruited from our outpatient as the study subjects.They were divided into three groups.The HAMD-17 and HAMA were used to test depression and anxiety levels of patients at different time points;Ottawa self-Injury Questionnaire(OSI) and Trait Coping Style Questionnaire(TCSQ) were used to assess self-injury and coping style of patients.Results:After 12 weeks of treatment,compared with the sertraline alone or dialectical treatment alone groups,the sertraline + dialectical behavior group had lower scores in HAMD-17,HAMA and TCSQ(negative scores),higher scores in the positive scores of TCSQ,and larger decline in the number of self-injury behavior(P=0.005).Conclusion:Dialectical behavior therapy combined with sertraline could improve the ability to deal with stressful life events in adolescent depression patients.

关 键 词：辩证行为疗法 舍曲林 非自杀性自伤 抑郁症 

分 类 号：R395.5[哲学宗教—心理学]