| 李高飞,李苗,张道龙.嗜睡障碍共病抽动障碍的临床访谈和治疗[J].四川精神卫生杂志,2021,34(2):172-176.Li Gaofei,Li Miao,Zhang Daolong,Interview and treatment of idiopathic hypersomnia comorbidity tics disorder[J].SICHUAN MENTAL HEALTH,2021,34(2):172-176 |
| 嗜睡障碍共病抽动障碍的临床访谈和治疗 |
| Interview and treatment of idiopathic hypersomnia comorbidity tics disorder |
| 投稿时间：2020-03-02 |
| DOI：10.11886/scjsws20210302001 |
| 中文关键词: 嗜睡障碍 抽动障碍 中枢兴奋剂 生物-心理-社会 |
| 英文关键词:Idiopathic Hypersomnia Tics disorder Stimulant Bio-psycho-social intervention |
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| 中文摘要: |
| 本文目的是呈现一例嗜睡障碍共病抽动障碍的临床诊疗思路及治疗方案的制定。咨客15岁，女性，高一年级学生，自幼存在频繁眨眼、歪嘴，诊断为抽动障碍，学习成绩一贯良好。自2020年新冠肺炎疫情以来，该咨客出现睡眠增多，平均每天睡眠12小时，伴日间睡眠增加，醒后疲惫乏力，学习成绩明显下降，被老师和家长多次批评，认为其学习态度不端正。咨客被诊断为嗜睡障碍共病持续性（慢性）运动或发声抽动障碍。建议采用生物-心理-社会综合干预的方法，生物治疗给予盐酸哌甲酯缓释片提高患者的觉醒程度，增强注意力，改善嗜睡的同时监测抽动症状的变化。心理治疗采用认知行为治疗，帮助患者纠正认知偏差，重塑认知结构，树立康复信心。采用正念治疗，帮助咨客调整情绪。社会资源方面，鼓励咨客积极探索资源，寻求社会支持，构建治疗联盟。在各方资源协调运行下，减少嗜睡症状，增强适应能力，继续完成学业。 |
| 英文摘要: |
| The purpose of this paper is to present the diagnosis and treatment of idiopathic hypersomnia comorbidity tics disorder. The client is 15 years old， female， a senior student， with frequent blinking and a crooked mouth since childhood， diagnosed with tics disorder. She previously had consistently good academic performance. Since the COVID-19 epidemic in 2020， the client has been sleeping more， averaging 12 hours per day， accompanied by increased daytime sleep with fatigue after waking up， and a significant decline in her studies. She was diagnosed with idiopathic hypersomnia comorbidity persistent （chronic） movement or tic disorder. It was suggested that she adopt a method of comprehensive biopsychosocial intervention. Biotherapy with methylphenidate can improve her arousal， enhance attention and improve drowsiness， meanwhile， changes to tic symptoms must be monitored. Cognitive behavioral therapy was used to help the client correct cognitive biases， reshape cognitive structure， and establish confidence in rehabilitation. Mindfulness therapy was adopted to help the client adjust her emotions. In terms of social resources， the client was encouraged to explore resources actively， seek social support， and build therapeutic alliances. Through coordinating multiple resources， the client reduced symptoms of sleepiness and enhanced her adaptability to continue with her studies. |
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