舍曲林联合理性情绪疗法对首发青少年抑郁症患者的临床观察  

Clinical observation of sertraline combined with rational emotion therapy for patients with primary adolescent depression

作　　者：徐金梅 张兆辉[2] 周晓香[1] 陈国华[1] 梅俊华[1] XU Jin-mei;ZHANG Zhao-hui;ZHOU Xiao-xiang;CHEN Guo-hua;MEI Jun-hua(The First Hospital of Wuhan,Wuhan 430022,China)

机构地区：[1]武汉市第一医院神经内科,430022 [2]武汉大学人民医院神经内科

出　　处：《临床精神医学杂志》2024年第2期90-94,共5页Journal of Clinical Psychiatry

基　　金：国家重点研发计划青年科学家项目(2021YFC2502200);武汉市医学科研项目(WX20B23)。

摘　　要：目的:探讨舍曲林联合理性情绪疗法对首发青少年抑郁症患者的临床疗效和安全性。方法:纳入2020年4月至2022年4月于武汉市第一医院神经内科睡眠与心理门诊就诊的首发青少年抑郁症患者90例,采用随机数字表法分为两组,研究组和对照组各45例,研究组采用舍曲林联合理性情绪疗法,对照组给予舍曲林治疗。于治疗前及治疗第4、8周末,采用汉密尔顿抑郁量表(HAMD)、症状自评量表(SCL-90)评估情绪状态,采用治疗副反应量表(TESS)评估药物的安全性。结果:治疗4周、治疗8周,两组的HAMD总分及焦虑/躯体化、认知障碍、阻滞、全身症状等因子分均较治疗前下降(P均<0.05),且研究组的HAMD总分、认知障碍、阻滞均低于对照组(P均<0.05),重复测量方差分析显示治疗8周的HAMD总粗分及认知障碍、睡眠障碍等因子分均低于治疗4周(P均<0.05)。研究组治疗4周、治疗8周的SCL-90总分均低于治疗前,且研究组低于对照组(P<0.05)。治疗后两组TESS评分对比差异无统计学意义(P>0.05),不良反应主要为恶心、头晕、嗜睡。结论:舍曲林联合理性情绪疗法可有效改善青少年抑郁症状,优于单一药物治疗,且安全性理想,值得临床推广应用。Objective:To explore the clinical efficacy and safety of sertraline combined with rational emotion therapy for adolescent patients with first-episode depression.Method:A total of 90 adolescent patients with first-episode depression who attended the sleep and psychological clinic of the First Hospital of Wuhan from April 2020 to April 2022 were selected and randomly divided into the research group and the control group,45 patients in each group.Patients of the research group were given sertraline combined with rational emotion therapy,patients of the control group were given sertraline.The Hamilton Depression Scale(HAMD)and symptom Self-evaluation Scale(SCL-90)were used to assess the emotional status before and at the end of the 4th and 8th week after treatment,while the safety of drugs was assessed using Treatment Emergent Symptom Scale(TESS).Results:Total HAMD scores and the score of anxiety/somatization、cognitive impairment、block、systemic symptoms decreased at the end of the 4th and 8th week after treatment compared with those before treatment(all P<0.05),while total HAMD gross score and the score of cognitive impairment and block of the study group were lower than that of the control group(all P<0.05).Repeated measures ANOVA showed that total HAMD score and the score of cognitive impairment and sleep disturbance at the end of the 8th week were lower than those at the end of the 4th week(all P<0.05).SCL-90 scores of the study group decreased at the end of the 4th and 8th week compared with those before treatment(all P<0.05),while the SCL-90 scores of the study group were significantly lower than those in the control group(P<0.05).There was no significant difference in TESS scores between the two groups after treatment(P>0.05).Conclusion:Sertraline hydrochloride combined with rational emotion therapy can effectively improve depressive symptoms in adolescents,better than single drug treatment,and less adverse effects,worthy of clinical promotion and application.

关 键 词：舍曲林 理性情绪疗法 青少年抑郁症 

分 类 号：R749.4[医药卫生—神经病学与精神病学]