松弛疗法联合舍曲林治疗儿童青少年首发抑郁发作的效果
Effect of relaxation therapy combined with sertraline in the treatment of first depressive episodes in children and adolescents
投稿时间:2023-09-10  修订日期:2024-06-06
DOI:
中文关键词:  儿童青少年,抑郁发作,松弛疗法
英文关键词:Children and adolescents  Depressive  Relaxation Therapy
基金项目:四川省医学科研课题计划(项目编号:S18020)
作者单位地址
刘 妍 川北医学院 四川省绵阳市游仙区剑南路东段190号绵阳市第三人民医院
敬 琳 四川省精神卫生中心·
绵阳市第三人民医院 
赵 荔 四川省精神卫生中心·
绵阳市第三人民医院 
周晓秋 四川省精神卫生中心·
绵阳市第三人民医院 
王 蕊 四川省精神卫生中心·
绵阳市第三人民医院 
蒋威巍 四川省精神卫生中心·
绵阳市第三人民医院 
李 杨 四川省精神卫生中心·
绵阳市第三人民医院 
王 丹* 四川省精神卫生中心·
绵阳市第三人民医院 
四川省绵阳市游仙区剑南路东段190号绵阳市第三人民医院儿童心理卫生科
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中文摘要:
      背景 抑郁发作已成为全球最常见的精神疾病之一,松弛疗法是抑郁发作的非药物治疗方法之一,但目前关于松弛疗法联合舍曲林治疗儿童青少年抑郁发作效果的研究有限。目的 探讨松弛疗法联合舍曲林治疗儿童青少年首发抑郁发作的效果,为儿童青少年抑郁发作的治疗提供参考。方法 于2019年1月1日—2020年12月31日,选取在四川省精神卫生中心儿童心理卫生科住院治疗的、符合《国际疾病分类(第10版)》(ICD-10)抑郁发作诊断标准的422例儿童青少年首发抑郁发作患者为研究对象。采用随机数字表法分为研究组(n=208)和对照组(n=214)。两组患者均接受舍曲林治疗,研究组在此基础上接受为期两周、每周五天、每次10天、每天1次、每次25~30 min的松弛治疗。分别于治疗前、治疗第2周末及出院第2周末采用汉密尔顿抑郁量表24项版(HAMD-24)和汉密尔顿焦虑量表(HAMA)进行评定。结果 共369例患者完成本研究,其中研究组185例(50.15%),对照组184例(49.86%)。两组HAMD-24总评分的时间效应、组别效应以及时间与组别的交互效应均有统计学意义(F=813.279、17.625、8 994.905,P均<0.01),两组HAMA总评分的时间效应、组别效应以及时间与组别的交互效应均有统计学意义(F=635.041、10.716、13 945.986,P均<0.01)。与治疗前相比,研究组在治疗第2周末及出院第2周末HAMD-24和HAMA评分均较低(t=0.924、0.359,P均<0.01)。出院第2周末,研究组HAMD-24和HAMA评分均低于对照组(t=0.210、0.720,P均<0.05)。治疗第2周末,研究组在抑郁症状、焦虑症状改善方面总有效率高于对照组(95.14% vs. 66.30%、89.18% vs. 71.74%,χ2=78.942、22.526,P均<0.05);出院第2周末,两组疗效比较,差异无统计学意义(P>0.05)。两组出现口干、恶心、便秘、腹泻、食欲下降、失眠/嗜睡、头晕/头痛及总不良反应率比较,差异均无统计学意义(χ2=0.552、0.009、0.100、0、0.177、0、0.205、0.173,P均>0.05)。结论 与单用舍曲林相比,松弛疗法联合舍曲林治疗在短期内对儿童青少年抑郁发作的效果可能更好。
英文摘要:
      Background The detection rate of depressive symptoms in children and adolescents is increasing year by year, and relaxation therapy has played a unique advantage as a psychotherapy, but there is limited research on relaxation therapy combined with sertraline in the treatment of depressive episodes in children and adolescents. Objective To explore the effect of relaxation therapy combined with sertraline on the first depressive episode in children and adolescents, and to provide a reference for the treatment of depressive episodes in children and adolescents. Methods From January 1, 2019 to December 31, 2020, 422 children and adolescents with first-episode depressive episodes who met the diagnostic criteria of the International Classification of Diseases, tenth edition (ICD-10) were selected as the study subjects. The study group (n=208) and the control group (n=214) were divided into the study group and the control group by random number table method. Patients in both groups were treated with sertraline, and the study group received relaxation therapy for 25~30 min for two weeks, five days a week, 10 days each time, once a day. The Hamilton Depression Scale 24-item (HAMD-24) and the Hamilton Anxiety Inventory (HAMA) were used before hospitalization, at the end of the second day of treatment, and at the end of the second day of discharge, respectively. Results A total of 369 patients completed this study, including 185 (50.15%) in the study group and 184 (49.86%) in the control group. There were statistically significant temporal effects, group effects, and time-group interaction effects of HAMD-24 total scores in the two groups(F=813.279, 17.625, 8 994.905, P<0.01). There were statistically significant temporal effects, group effects, and time-group interaction effects of HAMA total scores in the two groups(F=635.041, 10.716, 13 945.986, P<0.01). Compared with before treatment, the study group had lower HAMD-24 and HAMA scores at the end of the second week of treatment and the end of the second week of discharge(t=0.924, 0.359, P<0.01). At the end of the second day of discharge, the HAMD-24 and HAMA scores in the study group were lower than those in the control group(t=0.210, 0.720,P<0.05). At the end of the second week of treatment, the total effective rate of the study group was higher than that of the control group in terms of improvement of depressive symptoms and anxiety symptoms(95.14% vs. 66.30%, 89.18% vs. 71.74%,χ2=78.942, 22.526, P<0.05). At the end of the second day of discharge, there was no significant difference in efficacy between the two groups(P>0.05). There were no significant differences in the rates of dry mouth, nausea, constipation, diarrhea, decreased appetite, insomnia/drowsiness, dizziness/headache and total adverse reactions between the two groups(χ2=0.552、0.009、0.100、0、0.177、0、0.205、0.173,P>0.05). Conclusion Compared with sertraline alone,relaxation therapy combined with sertraline may have a better short-term effect on children and adolescents with depressive disorder.
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