儿童品行障碍心理与家庭综合治疗的疗效观察

Effect of psychotherapy combined with family therapy on childhood conduct disorder

目的探讨儿童品行障碍(CD)的心理卫生状况及其心理社会综合干预的临床疗效。方法将符合CCMD3诊断标准的40例CD患儿进行焦点解决短期治疗和家庭治疗的综合干预,疗程为3月,用症状自评量表(SCL90)和CD症状量表评估其心理卫生状况和临床疗效。结果临床治疗显效率和总有效率分别为67.5%(27例)和90.0%(36例)。治疗前CD患儿的SCL90评分与国内常模比较,除躯体化(S)、精神病性(P)及偏执(Pa)因子无显著差异外,其SCL90总分及强迫(Oc)、人际敏感(Is)、抑郁(D)、焦虑(A)、敌对(H)、恐怖(Ph)因子分均明显高于常模值(P<0.05或P<0.01);而治疗后上述计分均较治疗前显著降低(P<0.05或P<0.01)。结论焦点解决短期治疗结合家庭治疗能显著改善儿童强迫、抑郁、焦虑、敌对及恐惧等不良情绪,有效治疗品行障碍。

Objective To investigate the mental health status and the effect of the integrative psychosocial treatment on childhood conduct disorder （CD）. Methods Forty children with CD received solution-focused brief therapy（SFBT） along with family therapy for 3 months. The mental health status of patients was assessed through the symptom checklist （SCL-90） and the CD symptoms scale before and after treatment. Results After treatment, a significant efficacy of as high as 67.5% and a total response rate of 90.0% were achieved in children with CD. Compared with the domestic norm of SCL-90 scoring, the SCL-90 total score and the scores of 6 factors, including obsessive compulsive disorder,interpersonal sensitivity,depression,anxiety, hostility ,and phobic anxiety, in children with CD before treatment were significantly higher. After treatment the scores were reduced to the normal levels in children with CD. Conclusions SFBT combined with family therapy can significantly improve the obsessive compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility,and phobic anxiety in ehihtren with CD. It is effective in the treatment of CD.