认知行为治疗合并药物治疗对广泛性焦虑障碍青少年患者的效果

Study on the effect of cognitive behavioral therapy combined with medication on adolescent patients with generalized anxiety disorder

目的探讨认知行为治疗(CBT)合并药物治疗对广泛性焦虑障碍(GAD)青少年患者的效果。方法纳入68例13~22岁GAD青少年患者,采用随机数字表法分为CBT联合药物组(联合组)和药物组,进行8周药物治疗,联合组同时给予每周一次的CBT治疗。采用汉密尔顿焦虑量表(HAMA-14)和学生生活应激问卷(SLSI),于基线和治疗第4周、第8周测评,评估两组的疗效。结果联合组32例、药物组24例完成研究。基线时,两组患者在年龄、性别、受教育年限、独生子女方面比较,差异无统计学意义(P>0.05)。组内比较,联合组和药物组患者HAMA-14和SLSI得分均逐渐降低,差异均有统计学意义(HAMA-14:F=74.961,P<0.05;F=37.614,P<0.05;SLSI:F=28.818,P<0.05;F=30.137,P<0.05)。而且联合组得分降低更明显,4周末时两组间HAMA-14和SLSI得分比较差异有统计学意义(t=-2.348,P=0.023;t=-3.104,P=0.003),8周末时比较差异亦有统计学意义(t=-2.597,P=0.012;t=-3.639,P=0.001)。结论CBT联合组和药物组均能有效缓解GAD青少年患者的焦虑症状以及改善学生生活应激症状,CBT联合药物干预疗效优于单纯药物治疗。

Objective To explore the effect of cognitive behavioral therapy(CBT)combined with medication on adolescent patients with generalized anxiety disorder(GAD).Methods A total of 68 adolescent patients with GAD aged 13-22 years were divided into CBT combined with medication group(combined group)and medication group by random number table method,and were given 8 weeks medication treatment.Patients in the combined group were also given CBT once a week.Hamilton Anxiety Scale(HAMA-14)and studentLife Stress Inventory(SLSI)were used to evaluate the efficacy of both groups at baseline and the 4th and 8th week of treatment.Results 32 cases in the combined group and 24 cases in the medication group completed the study.At baseline,there was no statistically significant difference in age,sex,being the only child and years of education between the two groups(P>0.05).After 4 weeks of treatment,HAMA-14 and SLSI score in combined group were lower than those in medication group(t=-2.348,P=0.023;t=-3.014,P=0.003).After 8 weeks of treatment,there were statistically significant differences in HAMA-14 score and SLSI score between the two groups(t=-2.597,P=0.012;t=-3.639,P=0.001).After 8 weeks of treatment,compared within each group,the HAMA-14 and SLSI scores of the combined group and the medication group were gradually decreased,and the differences were statistically significant(HAMA-14:F=74.961,P<0.05;F=37.614,P<0.05;SLSI:F=28.818,P<0.05;F=30.137,P<0.05).Conclusions CBT combined group and medication group can effectively relieve the anxiety symptoms of adolescent patients with GAD and improve the student life stress symptoms.The effect of CBT combined intervention is better than that of medication treatment alone.