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氟西汀联合团体辩证行为疗法治疗伴有非自杀性自伤的青少年抑郁障碍患者
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Abstract:
目的:了解团体辩证行为疗法(dialectical behavior therapy, DBT)治疗伴有非自杀性自伤(non-suicidal self-injury, NSSI)行为的青少年抑郁障碍患者的临床疗效。方法:选择40名伴有NSSI的青少年抑郁障碍患者为研究对象,分为对照组和实验组,对照组应用氟西汀治疗,实验组应用氟西汀联合团体DBT治疗。比较两组患者治疗前、治疗4周后、治疗8周后的汉密尔顿抑郁量表(Hamilton depression scale, HAMD)、认知情绪调节量表(cognitive emotion regulation questionnaire, CERQ)、自我伤害想法和行为访谈表(self-injurious thoughts and behaviors interview, SITBI)的变化。结果:实验组比对照组在认知情绪调节和NSSI方面有更显著的改善(P < 0.05)。结论:团体DBT能够改变伴有NSSI的青少年抑郁障碍患者的认知情绪调节策略,有效减少其NSSI行为及想法的发生。
Objective: To study the clinical efficacy of group dialectical behavior therapy (DBT) in treating adolescent patients with depressive disorders accompanied by non-suicidal self-injury (NSSI). Methods: A total of 40 adolescent patients with depressive disorders accompanied by NSSI were selected as the subjects of the study, divided into a control group and an experimental group. The control group was treated with fluoxetine, while the experimental group received a combination of fluoxetine and group DBT. The changes in the Hamilton depression scale (HAMD), cognitive emotion regulation questionnaire (CERQ), and self-injurious thoughts and behaviors interview (SITBI) before treatment, after 4 weeks of treatment, and after 8 weeks of treatment were compared between the two groups. Results: The experimental group showed more significant improvements in cognitive emotion regulation and NSSI than the control group (P < 0.05). Conclusion: Group DBT can change the cognitive emotion regulation strategies of adolescent patients with depressive disorders accompanied by NSSI, effectively reducing the occurrence of NSSI behaviors and thoughts.
[1] | Oud, M., de Winter, L., Vermeulen-Smit, E., Bodden, D., Nauta, M., Stone, L., et al. (2019) Effectiveness of CBT for Children and Adolescents with Depression: A Systematic Review and Meta-Regression Analysis. European Psychiatry, 57, 33-45. https://doi.org/10.1016/j.eurpsy.2018.12.008 |
[2] | Lim, K., Wong, C.H., McIntyre, R.S., Wang, J., Zhang, Z., Tran, B.X., et al. (2019) Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis. International Journal of Environmental Research and Public Health, 16, Article No. 4581. https://doi.org/10.3390/ijerph16224581 |
[3] | 李伟, 李坤, 任育红, 等. 认知情绪调节策略与自伤行为: 体验回避的中介作用[J]. 中国健康心理学杂志, 2016, 24(10): 1549-1552. |
[4] | Adrian, M., McCauley, E., Berk, M.S., Asarnow, J.R., Korslund, K., Avina, C., et al. (2019) Predictors and Moderators of Recurring Self‐Harm in Adolescents Participating in a Comparative Treatment Trial of Psychological Interventions. Journal of Child Psychology and Psychiatry, 60, 1123-1132. https://doi.org/10.1111/jcpp.13099 |
[5] | 苏朝霞, 叶林. 团体辩证行为疗法——核心技术介绍[J]. 心理与健康, 2024(2): 44-46. |
[6] | 林信竹, 况利. 辩证行为疗法联合舍曲林药物治疗对伴非自杀性自伤抑郁症青少年的疗效[J]. 国际精神病学杂志, 2021, 48(3): 439-442+465. |
[7] | 汪晓静, 汤义平, 许瑞智, 等. 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[J]. 中国临床心理学杂志, 2024, 32(1): 234-237+197. |
[8] | 赵晓琳, 王琳, 闵艳艳. 辩证行为疗法联合舍曲林药物治疗对伴非自杀性自伤抑郁症青少年的疗效观察[J]. 心理月刊, 2023, 18(13): 115-117. |
[9] | 段登艾, 邓燕, 张志雄, 等. 辩证行为疗法联合舍曲林对伴有非自杀性自伤的青少年抑郁障碍患者的影响[J]. 临床荟萃, 2023, 38(4): 319-323. |
[10] | Whitlock, J., Prussien, K. and Pietrusza, C. (2015) Predictors of Self-Injury Cessation and Subsequent Psychological Growth: Results of a Probability Sample Survey of Students in Eight Universities and Colleges. Child and Adolescent Psychiatry and Mental Health, 9, Article No. 19. https://doi.org/10.1186/s13034-015-0048-5 |
[11] | Mehlum, L., Tørmoen, A.J., Ramberg, M., Haga, E., Diep, L.M., Laberg, S., et al. (2014) Dialectical Behavior Therapy for Adolescents with Repeated Suicidal and Self-Harming Behavior: A Randomized Trial. Journal of the American Academy of Child & Adolescent Psychiatry, 53, 1082-1091. https://doi.org/10.1016/j.jaac.2014.07.003 |
[12] | Hernandez-Bustamante, M., Cjuno, J., Hernández, R.M. and Ponce-Meza, J.C. (2023) Efficacy of Dialectical Behavior Therapy in the Treatment of Borderline Personality Disorder: A Systematic Review of Randomized Controlled Trials. Iranian Journal of Psychiatry, 19, 119-129. https://doi.org/10.18502/ijps.v19i1.14347 |
[13] | Foynes, M.M., Singh, R.S. and Landes, S.J. (2023) A Functional Approach to the Assessment and Treatment of Non-Suicidal Self-Injury in Veterans: A Dialectical Behavior Therapy-Informed Perspective. Cognitive and Behavioral Practice, 30, 64-81. https://doi.org/10.1016/j.cbpra.2021.10.005 |
[14] | DeCou, C.R., Comtois, K.A. and Landes, S.J. (2019) Dialectical Behavior Therapy Is Effective for the Treatment of Suicidal Behavior: A Meta-Analysis. Behavior Therapy, 50, 60-72. https://doi.org/10.1016/j.beth.2018.03.009 |
[15] | Weatherford, J.V., Ruork, A.K., Yin, Q., Lopez, A.C. and Rizvi, S.L. (2024) Shame, Suicidal Ideation, and Urges for Non‐Suicidal Self‐Injury among Individuals with Borderline Personality Disorder Receiving Dialectical Behavior Therapy: The Mediating Role of Anger. Suicide and Life-Threatening Behavior, 54, 338-348. https://doi.org/10.1111/sltb.13045 |