心理干预联合药物对网络游戏依赖儿童的疗效

Study on the treatment of children dependent on network game of psychological intervention combined with drug

目的 探讨心理干预联合药物治疗对网络游戏依赖儿童的疗效.方法 选取2009年2月至2013年10月来新乡医学院第二附属医院门诊诊治的112例网络游戏依赖儿童,按入院时间顺序随机分为药物治疗组、心理干预组2个对照组与心理干预联合药物治疗试验组.对照组各38例,试验组36例.药物治疗组患儿口服盐酸氟西汀胶囊10 mg,1次/d;心理干预组患儿予一般连续8周的心理谈话,直至出院;试验组在药物治疗基础上,采用认知重建、想象辩论、自我暗示、自我提醒的认知疗法和行为契约、行为强化、行为消退、厌恶刺激、自我约束为主的行为疗法.分别于治疗前、治疗2周末、4周末和8周结束后,应用中文网络成瘾量表（CIAS）、应付方式问卷（CSQ）和症状自评量表（SCL-90）对患儿各因子得分进行评定.结果 治疗2周末及8周结束时,试验组CIAS评分明显低于药物治疗组和心理干预组,差异均有统计学意义（t=2.49、2.03,P均＜0.05;t =2.72、2.72,P均＜0.01）;试验组CSQ应付方式问卷中的幻想、自责和退避3因子在治疗2周末、8周末的评分试验组低于2个对照组,差异均有统计学意义（t=3.99、3.78、2.15,P均＜0.05;t =2.64、4.20、3.72,P均＜0.01）;试验组解决问题和求助因子高于2个对照组,差异均有统计学意义（t=2.69、2.43;t=5.31、2.25,P均＜0.01）;试验组合理化因子评分在不同阶段与2个对照组比较差异均无统计学意义（P均＞0.05）.SCL-90总分在试验组和2个对照组之间的评分比较,差异均有统计学意义（t=5.05、4.31,P均＜0.01）.2个对照组之间各因子比较差异均无统计学意义（P均＞0.05）.结论 认知疗法、行为疗法为主的心理干预联合药物治疗对儿童网络游戏依赖的干预有较好疗效.

Objective To study the curative effect of psychological intervention combined with drug treatment of children addicted to the network game.Methods One hundred and twelve children addicted to the network game were selected,who were admitted to the outpatient department of the Second Affiliated Hospital of Xinxiang Medical University from Feb.2009 to Oct.2013 were selected,according to the admission time sequence,they were randomly divided into drug treatment group,psychological intervention group（as control group） and psychological intervention combined with drug therapy group（test group）.Each of the control groups had 38 cases of patients,while treatment group had 36 cases.Drug treatment group was treated with oral Fluoxetine Hydrochloride Capsules 10 mg,1 time/d; the psychological intervention group was given the general psychological conversation,until discharged from the hospital; the test group adopted the cognitive restructuring,imagine the debate,self suggestion,remind yourself of cognitive therapy and behavior contract,behavior reinforcement,behavior extinction,aversive stimulus,self-regulation of behavior therapy combined with drug therapy.Respectively,before treatment,2 weeks,4 weeks and 8 weeks after the end of the treatment,Chinese Internet Addiction Scale,Coping Style Questionnaire （CSQ） and symptom checklist 90 （SCL-90） of each factor were evaluated.Results By the end of the 2 weeks and 8 weeks after the treatment,CIAS scores in the treatment group were significantly lower than that in drug therapy and psychological intervention group,the differences were statistically significant （t =2.49,2.03,all P 〈 0.05 ; t =2.72,2.72,all P 〈 0.01） ; scores of 3 factors of fantasy,self accusation and retreat in CSQ group in coping style questiennaire in the coping style questionnaire in the treatment group were lower than those in control groups,the differences were statistically significant （t =3.99,3.78,2.15,all P 〈 0.05; t=2.64,4.20,3.72,all P 〈 0.01）; the problem solving,help seeking factor in the test group were higher than those in the control groups,the differences were statistically significant （t =2.69,2.43,5.31,2.25; all P 〈 0.01） ; variation test combined physicochemical factors scores at different stages had on difference comparison of those in the 2 control groups （all P 〉 0.05）.Comparison of the SCL-90 score between the test group and the 2 control groups,the differences were statistically significant （t =5.05,4.31,all P 〈 0.01）.There was no significant difference of the scores between the 2 control groups （all P 〉 0.05）.Conclusions Psycholoical intervention therapy including cognitive therapy,behavior therapy combined with drug treatment have good effect on children＇s addiction to Web games.