舍曲林联合生物反馈治疗伴非自杀性自伤的青少年抑郁症患者效果研究

Efficacy of Sertraline Combined with Biofeedback in the Treatment of Depression in Adolescents with Non-suicidal Self-injury

目的探讨舍曲林联合生物反馈治疗伴非自杀性自伤(NSSI)青少年抑郁症患者的效果。方法选取2021年3月—2023年2月门诊和住院治疗的98例伴NSSI青少年抑郁症患者,采用随机数字表法分为观察组及对照组各49例。观察组给予舍曲林联合生物反馈治疗,对照组给予舍曲林治疗,均治疗8周。比较2组临床疗效,治疗前后汉密尔顿抑郁量表(HAMD)评分、抑郁自评量表(SDS)评分、NSSI行为和功能量表(ANSSIQ)评分,治疗前后血清多巴胺(DA)、5-羟色胺(5-HT)和同型半胱氨酸(Hcy)水平,以及治疗期间不良反应及副反应量表(TESS)评分。结果观察组总有效率(93.88%,46/49)高于对照组(77.55%,38/49)(P<0.05)。治疗2周、治疗4周和治疗8周后,2组HAMD评分、SDS评分与治疗前比较逐步降低,且观察组治疗4周和治疗8周后HAMD评分、SDS评分较对照组更低(P<0.05)。治疗后2组血清DA、5-HT均高于治疗前,且观察组比对照组更高(P<0.05,P<0.01);治疗后2组Hcy、ANSSIQ各评分低于治疗前,且观察组比对照组更低(P<0.05,P<0.01)。2组不良反应及TESS评分比较无差异(P>0.05)。结论舍曲林联合生物反馈治疗效果较好,可较好改善伴NSSI青少年抑郁症患者抑郁症状、NSSI行为。

Objective To investigate the effect of Sertraline combined with biofeedback therapy in the treatment of adolescent depression with non-suicidal self-injury(NSSI).Methods From March 2021 to February 2023,98 outpatient and inpatient adolescents with depression and NSSI were selected and divided into observation group(n=49)and the control group(n=49)according to random number table method.The observation group received Sertraline combined with biofeedback therapy,and the control group received Sertraline.The course of treatment was 8 weeks.The clinical efficacy,Hamilton Depression Scale(HAMD)score,Self-rating Depression Scale(SDS)score,NSSI Behavior and Function Scale(ANSSIQ)score,serum dopamine(DA),5-hydroxytryptamine(5-HT)and homocysteine(Hcy)levels before and after treatment as well as adverse reactions during treatment and Treatment Emergent Symptom Scale(TESS)scores were compared.Results After treatment,the total effective rate of observation group(93.88%,46/49)was higher than that of the control group(77.55%,38/49)(P<0.05).At 2,4 and 8 weeks after treatment,HAMD scores and SDS scores of the two groups showed a decreased trend compared with those before treatment,which were lower at 4 and 8 weeks after treatment in the observation group than in the control group(P<0.05).After treatment,the serum DA and 5-HT in the two groups were higher than those before treatment,which were higher in the observation group than in the control group(P<0.05,P<0.01).The scores of Hcy and ANSSIQ were lower than those before treatment,which were lower in the observation group than in the control group(P<0.05,P<0.01).Conclusion Sertraline combined with biofeedback therapy is effective,which can improve the symptoms of depression and NSSI behavior in adolescents with depression and NSSI.