辩证行为疗法联合碳酸锂治疗青少年非自杀性自伤患者的效果分析  

Effectiveness of dialectical behavior therapy combined with lithium carbonate in adolescents with nonsuicidal self-injury

作　　者：李哲 王慧 邢轶环 纪经纬 李美玲 Li Zhe;Wang Hui;Xing Yihuan;Ji Jingwei;Li Meiling(Second Clinical Department,Qinhuangdao Jiulongshan Hospital,Qinhuangdao 066000,China;Eighth Clinical Department,Qinhuangdao Jiulongshan Hospital,Qinhuangdao 066000,China;First Clinical Department,Qinhuangdao Jiulongshan Hospital,Qinhuangdao 066000,China;Department of Neuropathic Pain,Bone and Joint Rehabilitation,Hebei Rehabilitation Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市九龙山医院临床二科,066000 [2]河北省康复医院神经疼痛骨关节康复科,秦皇岛066000 [3]秦皇岛市九龙山医院临床八科,066000 [4]秦皇岛市九龙山医院临床一科,066000

出　　处：《神经疾病与精神卫生》2024年第12期851-857,共7页Journal of Neuroscience and Mental Health

基　　金：秦皇岛市科学技术研究与发展计划(202301A041)。

摘　　要：目的初步验证辩证行为疗法(DBT)联合碳酸锂治疗青少年非自杀性自伤(NSSI)患者的效果。方法选取2023年6月1日—12月31日在秦皇岛市九龙山医院就诊的60例青少年NSSI门诊患者为研究对象,采用随机数字表法按1∶1将其分为DBT组和DBT+碳酸锂组,每组各30例。DBT组予以单一DBT治疗,DBT+碳酸锂治疗组在DBT治疗基础上给予碳酸锂治疗。分别于基线期、治疗后第3个月、治疗后第6个月,采用青少年非自杀性自伤行为评定问卷、非自杀性自伤功能问卷、24项汉密尔顿抑郁量表(HAMD-24)、杨氏躁狂评定量表(YMRS)评价两组受试者NSSI行为及功能状况、抑郁及躁狂症状严重程度。两组间一般资料及各观察指标比较采用t检验、Mann-Whitney U检验、χ2检验比较,采用重复测量方差分析对组别和随访时间交互作用显著的或组别/随访时间主效应显著的进一步进行简单效应分析。结果治疗前,两组患者青少年非自杀性自伤行为问卷、功能问卷总分及各维度得分比较,差异均无统计学意义(均P>0.05)。治疗后第3、6个月时,DBT+碳酸锂组患者青少年非自杀性自伤行为问卷、功能问卷总分及各维度得分均低于DBT组,差异均有统计学意义(均P<0.05)。重复测量方差分析显示,青少年非自杀性自伤行为问卷以及功能问卷的总分及各维度评分在不同治疗时间主效应、组别主效应、时间与分组交互效应均显著(均P<0.05)。简单效应分析表明,DBT+碳酸锂组患者在治疗后3个月、6个月的青少年非自杀性自伤行为问卷以及功能问卷总分及各维度得分均低于DBT组(均P<0.05)。治疗后第3、6个月,DBT+碳酸锂组患者NSSI发生率均低于DBT组,差异均有统计学意义(均P<0.05)。两组间基线期HAMD-24、HAMA与YMRS量表评分比较,差异均无统计学意义(P>0.05);重复测量方差分析显示,HAMD-24、HAMA与YMRS评分在不同治疗时间主效应、组别主效应以及时间Objective To preliminarily verify the effectiveness of dialectical behavior therapy(DBT)combined with lithium carbonate in adolescents with non-suicidal self-injury(NSSI).Methods From June 1 to December 31,2023,60 adolescents with NSSI visiting Qinhuangdao Jiulongshan Hospital were selected as subjects.The subjects were divided into DBT group and DBT+lithium carbonate group by 1∶1 using randomized numerical table method,30 cases in each group.DBT group was treated with single DBT,and DBT+lithium carbonate group was given lithium carbonate in addition to DBT.At baseline,three months after treatment,and six months after treatment,the Adolescent Non-suicidal Self-injury Assessment Questionnaire(ANSAQ),Non-suicidal Self-injury Function Questionnaire,Hamilton Depression Rating Scale-24(HAMD-24),and Young Mania Rating Scale(YMRS)were used to evaluate the NSSI behavior and functional status,as well as the severity of depression and mania symptoms in both groups of subjects.The general information and observation indicators between the two groups were compared using t-test,Mann-Whitney U test,and chi square test.Simple effects analysis was conducted using repeated measures analysis of variance for those with significant interaction between groups and follow-up time or significant main effects between groups/follow-up time.Results Before treatment,there was no statistically significant difference in the total scores and dimension scores of ANSAQ and Non-suicidal Self-injury Function Questionnaire between the two groups of patients(P>0.05).At the third and sixth months after treatment,the total scores of ANSAQ and Non-suicidal Self-injury Function Questionnaire and the scores of each dimension of the patients in DBT+lithium carbonate group were lower than those of DBT group,and the differences were all statistically significant(P<0.05).Repeated-measures analysis of variance showed that the total and dimension scores of ANSAQ as well as Non-suicidal Self-injury Function Questionnaire were statistically significant for dif

关 键 词：青少年 辩证行为疗法 非自杀性自伤 碳酸锂 焦虑 抑郁 躁狂症状 

分 类 号：R749[医药卫生—神经病学与精神病学]