辩证行为疗法联合氟西汀治疗青少年抑郁症伴非自杀性自伤行为的临床观察  

Clinical observation of dialectical behavior therapy combined with fluoxetine in the treatment of adolescent depression with non-suicidal self-injury behavior

作　　者：赖忠红 肖峰 钟伦淳 蔡文婷 刘雪琴 LAI Zhonghong;XIAO Feng;ZHONG Lunchun;CAI Wenting;LIU Xueqin(Department of Chronic Psychiatry,The Third People's Hospital of Ganzhou,Ganzhou,Jiangxi,341000,China;Department of Early Intervention,The Third People's Hospital of Ganzhou,Ganzhou,Jiangxi,341000,China;Department of Emotional Disorders,The Third People's Hospital of Ganzhou,Ganzhou,Jiangxi,341000,China;Department of Pediatric Psychology,The Third People's Hospital of Ganzhou,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市第三人民医院慢性精神科,江西赣州341000 [2]赣州市第三人民医院早期干预科,江西赣州341000 [3]赣州市第三人民医院情感障碍科,江西赣州341000 [4]赣州市第三人民医院儿少心理科,江西赣州341000

出　　处：《当代医学》2024年第25期29-33,共5页Contemporary Medicine

基　　金：江西省卫生健康委科技计划(202312071)。

摘　　要：目的探讨辩证行为疗法(dialectical behavior therapy,DBT)联合氟西汀治疗青少年抑郁症伴非自杀性自伤(non-suicidal self-injury,NSSI)行为的效果。方法选取2021年5月至2022年10月赣州市第三人民医院收治的72例青少年抑郁症伴NSSI行为患儿作为研究对象,采用随机数字表法分为对照组与研究组,每组36例。对照组采用氟西汀治疗,研究组采用DBT联合氟西汀治疗。比较两组心理弹性、抑郁症状、自伤行为、冲动性、攻击行为、应激性生活事件。结果治疗后,两组坚韧性、力量性、乐观性评分及总分均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分、自伤功能评定量表(functional assessment of self-mutilation,FASM)评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组运动冲动性、认知冲动性、无计划冲动性评分及总分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组语言攻击、财产攻击、自身攻击、体力攻击评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组人际关系因子、学习压力因子、受惩罚因子、丧失因子、健康适应因子、其他评分及总分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。结论DBT联合氟西汀治疗青少年抑郁症伴NSSI行为患儿疗效显著,能有效提高患儿心理弹性,改善其抑郁症状,缓解冲动性与攻击性,减少自伤行为发生。Objective To investigate the effects of dialectical behavior therapy(DBT)combined with fluoxetine in the treatment of adolescent depression with nonsuicidal self-injury(NSSI).Methods A total of 72 adolescent children with depression and NSSI behavior admitted to The Third People's Hospital of Ganzhoul from May 2021 to October 2022 were selected as the study subjects,and they were divided into the control group and the study group by random number table method,with 36 cases in each group.The control group was treated with fluoxetine,and the study group was treated with DBT combined with fluoxetine.The psychological resilience,depressive symptoms,self-injurious behavior,impulsivity,aggression and stressful life events were compared between the two groups.Results After treatment,the scores of resilience,strength,optimism and total score of the two groups were higher than before treatment,and the study group was higher than the control group,and the differences were statistically sig-nificant(P<0.05).After treatment,the Hamilton depression scale(HAMD)scores and functional assessment of self-mutilation(FASM)scores of the two groups were lower than before treatment,and the study group was lower than the control group,and the differences were statistically signifi-cant(P<0.05).After treatment,the scores of motor impulsivity,cognitive impulsivity,unplanned impulsivity and total scores of the two groups were lower than before treatment,and the study group was lower than the control group,and the differences were statistically significant(P<0.05).After treatment,the scores of language attack,property attack,self attack and physical attack of the two groups were lower than before treatment,and the study group was lower than the control group,and the differences were statistically significant(P<0.05).After treatment,the interpersonal relationship factors,learning stress factors,punishment factors,loss factors,health adaptation factors,other scores and total scores of the two groups were lower than before treatment,and the st

关 键 词：青少年 抑郁症 氟西汀 辩证行为疗法 非自杀性自伤行为 

分 类 号：R74[医药卫生—神经病学与精神病学]