刘妍,敬琳,赵荔,周晓秋,王蕊,蒋威巍,李杨,王丹.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[J].四川精神卫生杂志,2024,37(6):502-506.Liu Yan,Jing Lin,Zhao Li,Zhou Xiaoqiu,Wang Rui,Jiang Weiwei,Li Yang,Wang Dan,Efficacy of relaxation therapy combined with sertraline in the treatment of new-onset depressive episode in children and adolescents[J].SICHUAN MENTAL HEALTH,2024,37(6):502-506

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

Efficacy of relaxation therapy combined with sertraline in the treatment of new-onset depressive episode in children and adolescents

投稿时间：2023-09-10

DOI：10.11886/scjsws20230910003

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 episode Relaxation therapy

基金项目:四川省医学科研课题（项目名称：药物联合工娱治疗治疗儿童首发抑郁障碍疗效观察，项目编号：S18020）

作者	单位	邮编
刘妍	川北医学院，四川南充 637000 四川省精神卫生中心·绵阳市第三人民医院，四川绵阳 621000	621000
敬琳	四川省精神卫生中心·绵阳市第三人民医院，四川绵阳 621000	621000
赵荔	四川省精神卫生中心·绵阳市第三人民医院，四川绵阳 621000	621000
周晓秋	四川省精神卫生中心·绵阳市第三人民医院，四川绵阳 621000	621000
王蕊	四川省精神卫生中心·绵阳市第三人民医院，四川绵阳 621000	621000
蒋威巍	四川省精神卫生中心·绵阳市第三人民医院，四川绵阳 621000	621000
李杨	四川省精神卫生中心·绵阳市第三人民医院，四川绵阳 621000	621000
王丹^*	四川省精神卫生中心·绵阳市第三人民医院，四川绵阳 621000	621000

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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的效果的研究有限。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例儿童青少年患者。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2周、每周5天、每天1次、每次25~30 min的松弛疗法治疗。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，对照组184例。两组HAMD-24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）。治疗第2周末及出院第2周末，研究组HAMD-24和HAMA评分均较低治疗前（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，研究组抑郁症状和焦虑症状改善总有效率均高于对照组（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）。两组不良反应发生率比较，差异均无统计学意义（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 depressive episode is one of the most prevalent mental illnesses worldwide. Relaxation therapy as a psychotherapy for depressive disorder has shown itself to be a viable tool， yet the existing research on relaxation therapy combined with sertraline in the treatment of depressive episodes in children and adolescents is severely limited.Objective To discuss the effect of relaxation therapy combined with sertraline on the new-onset depressive episodes in children and adolescents， and to provide references for the treatment of depressive episodes in children and adolescents.Methods From January 1， 2019 to December 31， 2020， a sample of 422 children and adolescents with depressive episodes attending the Child Mental Health Department of Sichuan Mental Health Center and fulfilling the International Classification of Diseases， tenth edition （ICD-10） diagnostic criteria were enrolled， and they were classified into study group （n=208） and control group （n=214） using random number table method. All participants were offered sertraline， based on this， study group was assigned to relaxation therapy for 25~30 min per day， five days per week for a period of two weeks. Hamilton Depression Scale 24-item （HAMD-24） and Hamilton Anxiety Scale （HAMA） were applied at the enrollment， the end of 2 weeks of treatment and the end of the 2^nd week after discharge.Results A total of 369 patients completed the study， including 185 in study group and 184 in control group. Analysis on HAMD-24 scores revealed a significant time effect， group effect and time×group interaction effect （F=813.279， 17.625， 8 994.905， P<0.01）. Significant time effect， group effect， and time×group interaction effect were noted on HAMA scores （F=635.041， 10.716， 13 945.986， P<0.01）. A reduction in HAMD-24 and HAMA scores was reported in study group at end of 2 weeks of treatment and end of the 2^nd week after discharge compared with baseline （t=0.924， 0.359， P<0.01）. At the end of the 2^nd week after discharge， study group scored lower on HAMD-24 and HAMA compared to control group （t=0.210， 0.720， P<0.05）. At the end of 2 weeks of treatment， study group resulted in greater improvements in depressive symptoms and anxiety symptoms than those of control group （95.14% vs. 66.30%， 89.18% vs. 71.74%， χ²=78.942， 22.526， P<0.05）. The overall efficacy rate yielded no statistical difference between two groups at end of the 2^nd week after discharge （P>0.05）， and no statistical difference was found in the adverse reactions between the two groups （P>0.05）.Conclusion Compared with sertraline alone， its combination with relaxation therapy may achieve a better short-term efficacy in the treatment of depressive episode in children and adolescents. ［Funded by Sichuan Medical Scientific Research Project （number， S18020）］

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