Effects of Internet-Based Acceptance and Commitment Therapy (IACT) on Adolescents: A Systematic Review and Meta-Analysis

Objectives:This study reviewed published randomized controlled trials(RCTs)and evaluated the efficacy of internet-based acceptance and commitment therapy(IACT)on adolescent mental health.Methods:Searches were conducted in PubMed,ProQuest,APA(PsycNET/PsycINFO),and Web of Science from inception to Jan-uary 2022 to identify RCTs evaluating the effects of IACT on adolescents.The included studies were assessed for quality and risk of bias.This study was performed using the standard mean difference and associated 95%confidence interval of effective measures.Review Manager 5.4 software was adopted to calculate the effect size.Results:Compared to adolescents in control groups,those in the IACT groups showed some improvement in the efficacy of depression symptoms(SMD=−0.24,95%CI=[−0.44,−0.05],p=0.01)and had a small but sig-nificant effect on reducing experiential avoidance(SMD=−0.24,95%CI=[−0.46,−0.01],p=0.04).However,the effect size on anxiety did not reach the threshold(SMD=−0.18,95%CI=[−0.27,−0.09],p<0.0001).In addition,there were no significant differences in stress and well-being compared to those of the control group.Compared with universal adolescents,IACT was found to have a more significant therapeutic effect on targeted adolescents.Conclusions:IACT is effective in adolescent mental health interventions,but its clinical reliability and significant efficacy are limited,and more rigorous RCTs are needed in future studies.

The optimal atropine concentration for myopia control in Chinese children: a systematic review and network Metaanalysis

AIM:To figure out whether various atropine dosages may slow the progression of myopia in Chinese kids and teenagers and to determine the optimal atropine concentration for effectively slowing the progression of myopia.METHODS:A systematic search was conducted across the Cochrane Library,PubMed,Web of Science,EMBASE,CNKI,CBM,VIP,and Wanfang database,encompassing literature on slowing progression of myopia with varying atropine concentrations from database inception to January 17,2024.Data extraction and quality assessment were performed,and a network Meta-analysis was executed using Stata version 14.0 Software.Results were visually represented through graphs.RESULTS:Fourteen papers comprising 2475 cases were included;five different concentrations of atropine solution were used.The network Meta-analysis,along with the surface under the cumulative ranking curve(SUCRA),showed that 1%atropine(100%)>0.05%atropine(74.9%)>0.025%atropine(51.6%)>0.02%atropine(47.9%)>0.01%atropine(25.6%)>control in refraction change and 1%atropine(98.7%)>0.05%atropine(70.4%)>0.02%atropine(61.4%)>0.025%atropine(42%)>0.01%atropine(27.4%)>control in axial length(AL)change.CONCLUSION:In Chinese children and teenagers,the five various concentrations of atropine can reduce the progression of myopia.Although the network Meta-analysis showed that 1%atropine is the best one for controlling refraction and AL change,there is a high incidence of adverse effects with the use of 1%atropine.Therefore,we suggest that 0.05%atropine is optimal for Chinese children to slow myopia progression.

The Relationship between Myopia and Ocular Alignment among Rural Adolescents

Purpose: The prevalence of myopia in school-age children and rural area in Taiwan has increased dramatically. The aim of this study was to explore the associated factors of myopia in rural ado-lescents. Methods: A cross sectional design with a rural junior high student was invited to partici-pate in this study. The relationship between refraction error (RE), spectacle fitting condition, and ocular alignment was determined by stereoacuity. The RE was determined using autorefractor. The ocular alignment was evaluated by cover-uncover test. Stereoacuity was measured by Titmus test. The examination about spectacle fitting included the lens power, lens transparency, pupil distance, frame size, and distortion of the frame. Multiple linear regression was used to determine the effect of the spectacle suitability and ocular alignment on the RE and stereoacuity. Results: The prevalence of myopia was 78% in a total of 338 adolescents, and the incidence of high myopia (≤-6 Diopter, D) accounted for 10.2%. Participant worn poor-fitting spectacles were found with more myopia (-3.95D vs -3.42D, p = 0.02). The exophoria or exotropia significantly increased RE (p < 0.01). The eye position was significantly associated with decreased steroacuity function (p = 0.03). Head position demonstrated to have a significant relationship with stereoacuity (p = 0.03). Conclusions: Good-fitting spectacles provided a good visual function and were associated with less RE condition. Exotrope showed a significant correlation with myopia and stereoacuity. The health care providers should be aware of the ocular alignment in myopic suffers.

Analysis of the Prevalence and Situation of Myopia in Adolescents from South China

Purpose: To conduct dynamic detection of refraction changes in adolescents with myopia and analyze the correlation between different reexamination times and factors that included age of onset, initial refractive power, and rate of myopia progression.Methods: A total of 900 adolescents(aged 6-15 years) with myopia admitted to Zhongshan Ophthalmic Center between2009 and 2013 were randomly selected in this investigation.All participants underwent objective refraction measurement with an autorefractometer(Topcon 8900) or streak retinoscopy and subjective refraction detection with an autorefractor(Nidek).or minus-lens procedures at different time intervals(6months, 1, and 2 years). Accurate refractive power was obtained..All data were analyzed with SPSS 18.0 statistical software.Results:.The mean refractive power was increased by 0.56 ±0.37 diopters(D) after 6 months,.by 0.83±0.45 D after 1 year,.and by 1.50±0.70 D after 2 years..Among the 900 adolescents,.the most rapid increase in refractive power was observed at the age of 8 years at the 6-month reexamination, at the age of8 and 9 years at the 1-year reexamination,.and at the age of 7-9 years at the 2-year reexamination..The increase in index of refraction tended to diminish with aging..The different cycles of reexamination revealed a slowing of the rate of myopia progression along with the increase in the initial index of refraction..The highest rate of myopia progression was noted in low-myopic adolescents with initial refractive power ranging from-0.25 to 2.75 D.Conclusion:.No positive correlation was documented between different cycles of reexamination and the refractive power. The increase in refractive power was associated with factors that included the reexamination cycle, age of onset, and initial refractive power.

Cognitive behavioral therapy group intervention for HIV transmission risk behavior in perinatally infected adolescents

Purpose: This study analyzed treatment effects of cognitive behavioral therapy (CBT) group counseling intervention on HIV transmission risk behavior, depression, anxiety, and alcohol use in HIV perinatally infected adolescents attending an HIV clinical care center in Uganda, Africa. Method: A total of 186 adolescents were randomly assigned to an experimental or control arm and assigned into groups of 11 - 16 adolescents. The experimental groups received an 80-minute CBT based weekly intervention for 8 consecutive weeks, while the control groups received only standard group care. Data from self report assessments were analyzed at pre- and post-test using repeated measures of analysis of variance. The participants, analyzed by variable, included 115 for sexual behavior, 106 for depression, 88 for anxiety, and 115 for alcohol use. Results: The results from the study show a large significant difference (p = 0.006) between the experimental and control groups on the anxiety variable. There were no significant differences between the experimental and control groups on the variables of sexual behavior (p = 0.876), depression (p = 0.700), and alcohol use (p = 0.815). There was an indication of reduced levels of HIV sexual transmission risk behavior, depression, and alcohol use levels in the participants in both the experimental and control groups. Conclusions: Risky sexual behavior places HIV perinatally infected adolescents at risk of re-infection, sexually transmitted diseases, and transmitting HIV to their sexual partners. CBT group counseling intervention equipped the participating adolescents with appropriate life skills to deal with psychological distress and anxiety often seen in their lives and may be useful in routine medical care to reduce transmission risks and improve wellness and call for its incorporation into HIV preventive programs and counselor education.

Effect of Behavioural Therapy on Depression in Adolescents with Sickle Cell Disease

Background: Depression, one of the commonest mental health problems in SCD, has high prevalence rates. While psychological therapies have been found to be beneficial in mild to moderate depression, their use as non-pharmacological methods amongst adolescents in sub-Saharan Africa, particularly Nigeria, is still at its infancy. Objective: To determine the effect of behavioural activation therapy on depression in adolescents living with Sickle Cell Disease attending out-patient clinic at the Lagos State University Teaching Hospital, Lagos, Nigeria. Method: The study was conducted in Lagos State University Teaching Hospital, Lagos, Nigeria, between November 2017 to February 2018 (4 months) among adolescents living with SCD and depression attending out-patient clinic. A randomized control trial (RCT) was conducted among participants assigned to treatment (30) versus control (30) group. A manualized behavioral therapy programme developed was delivered to the treatment group. The data was analysed using the Statistical Package for Social Sciences (SPSS) version 23. Pair T-test was used to compare the two groups across continuous variables, pre- and post intervention. Analysis of Covariance (ANCOVA) was used to determine treatment effects controlling for baseline scores. Result: After the intervention, the mean depression score reduced from 22.13 ± 3.08 to 13.02 ± 4.56 while Paediatric quality of life score increase from 62.57 ± 17.85 to 67.90 ± 7.99 in the treatment group (BDI, p < 0.001;PedsQL, p = 0.045). However, the pre- and post-intervention mean depression scores in the control group showed insignificant reduction from 22.23 ± 3.24 to 21.60 ± 2.75 and mean PedsQL from pre-intervention scores of 59.67 ± 12.60 to 56.73 ± 8.94 post intervention (BDI, p = 0.388;PedsQL, p = 0.242). From multivariate analysis (ANCOVA), only the Quality of Life scores ceased to show any significant effect of the intervention. Conclusion: This study further strengthens and supports the extant literature that behavioral therapy alone is efficacious for depressive.

Effect of Narrative Therapy on the Psychological Status and Life Quality of Family Caregivers of Adolescents with First-episode Depression

[Objectives]The research aimed to explore the effect of narrative therapy on the negative emotion,quality of life,care burden and nursing satisfaction of family caregivers of adolescents with first-episode depression.[Methods]Using convenient sampling method,the family caregivers of the adolescents with first-episode depression hospitalized in the Children and Adolescents Psychology Department of a GradeⅢLevel A hospital in Shiyan City,Hubei Province from July 2021 to April 2022 were selected as the research objects.The coin toss method was used to determine the test group and the control group,with 60 cases in each group.The control group received routine nursing care,and the experimental group implemented narrative therapy on this basis.Self-rating anxiety scale,self-rating depression scale,health status questionnaire(SF-36),and caregiver burden inventory were used to evaluate the anxiety and depression level,quality of life,and care burden level of the caregivers before and after the intervention.The nursing satisfaction questionnaire was used to evaluate the nursing satisfaction to the caregivers after the intervention.[Results]After 8 weeks of intervention,4 cases fell off in the control group and 3 cases fell off in the intervention group.The scores of anxiety and depression in the two groups were lower than those before intervention,and the scores in the test group were significantly lower than those in the control group(P<0.05).The life quality scores of life vitality,emotional function and mental health dimensions were higher than before the intervention,and the scores in the test group were significantly higher than those in the control group(P<0.05).The total score of care burden and the scores in time dependence,development limitation and physiological dimension of the two groups were lower than those before intervention,but the difference was not statistically significant(P>0.05).[Conclusions]Narrative therapy can effectively alleviate the negative emotions of family caregivers of adolescents with first-episode depression,and improve their quality of life and nursing satisfaction,but not their care burden.

Helping adolescents develop self-realization using art therapy

This report explored psychodynamic developments that adolescents undergo in their process of self-realization and self-identification, including separation-individuation and ego development. The paper maked a case for art therapy as a resource and non-confrontational outlet to guide adolescents through their development and search for their self-identity. The role of the art therapist is presented as an alternative source of support and containment which may be lacking through the adolescents’ peers and parents. The paper ultimately argued that art therapy had many therapeutic qualities that could help the adolescent in their search and consolidation of the self.

Treatment of hepatitis B virus infection in children and adolescents

Hepatitis B virus(HBV)infection is one of the main causes of morbidity and mortality worldwide.Most children acquire the infection perinatally or during early childhood and develop a chronic hepatitis characterized by a high viral replication and a low-inflammation phase of infection,with normal or only slightly raised aminotransferases.Although a conservative approach in children is usually recommended,different therapies exist and different therapeutic approaches are possible.The main goals of antiviral treatment for children with chronic HBV infection are to suppress viral replication and to warn the disease progression to cirrhosis and hepatocellular carcinoma,although these complications are rare in children.Both United States Food and Drug Administration(USFDA)and European Medicines Agency(EMA)have approved interferon alfa-2b for children aged 1 year and older,pegylated interferon alfa-2a and lamivudine for children aged 3 years and older,entecavir for use in children aged 2 years and older,and adefovir for use in those 12 years of age and older.Tenofovir disoproxil fumarate is approved by EMA for children aged 2 years and older and by USFDA for treatment in children aged 12 years and older.Finally,EMA has approved the use of tenofovir alafenamide for treatment of children aged 12 years and older or for children weighing more than 35 kg independent of age.This narrative review will provide the framework for summarizing indications to antiviral therapy in the management of chronic HBV infection in children and adolescents.

Comparison of IOL-Master 700 and IOL-Master 500 biometers in ocular biological parameters of adolescents

AIM:To compare the differences and consistency of IOL-Master 700 biometers applying swept optical coherence tomography with the conventional IOL-Master 500 applying partial coherence interference in terms of the ocular biological parameters in adolescents with ametropia.METHODS:A total of 110 adolescents(110 eyes)with ametropia were collected,including 55 males and 55 females;age 10.69±2.81 y.Ocular biological measurements were taken by IOL-Master 700 and IOL-Master 500 respectively to obtain biological parameters including axial length(AL),mean corneal anterior surface keratometry(K_(m)),anterior chamber depth(ACD),and horizontal corneal diameter(WTW).Paired t-test was used to compare the differences between the two instruments.The intra-group correlation coefficient(ICC)and the Bland-Altman analysis were used to evaluate the consistency of parameter measurements between the two instruments for the four biological parameters.RESULTS:Statistical analysis showed that there was no significant difference in the K_(m)value measured by IOL-Master 700 and IOL-Master 500(t=-1.644,P=0.116).The average differences of the AL,ACD,and WTW distances between the two instruments are 0.028,0.101 and 0.064 mm respectively,and the differences are statistically significant(t=2.644,12.505,3.911,P<0.001).The consistency study results indicated high correlation in the measurement of AL,K_(m),ACD and WTW between the two instruments(ICC=0.994,0.873,0.927,0.912).CONCLUSION:The novel biometric instrument IOL-Master 700 makes no difference with IOL-Master 500 in the measurement of K_(m).There are some differences in the values of AL,ACD,and WTW.However,the two instruments show good consistency in these four biological measurements.The measured values of K_(m)are interchangeable between the instruments.These two types of biometrics can be used as mutual reference in consideration of that the differences in AL,ACD,and WTW measurements are not sufficient to produce clinically meaningful differences.

Axial length shortening in myopic children with Stickler syndrome after repeated low-level red-light therapy

AIM:To report the myopia-controlling effect of repeated low-level red-light(RLRL)therapy in patients with Stickler syndrome(STL),an inherited collagenic disease typically presenting with early onset myopia.METHODS:Three STL children,aged 3,7,and 11y,received RLRL therapy throughout the follow-up period of 17,3,and 6mo,respectively after exclusion of fundus anomalies.Data on best-corrected visual acuity(BCVA),intraocular pressure,cycloplegic subjective refraction,ocular biometrics,scanning laser ophthalmoscope,optical coherence tomography,genetic testing,systemic disease history,and family history were recorded.RESULTS:At the initiation of the RLRL therapy,the spherical equivalent(SE)of 6 eyes from 3 patients ranged from-3.75 to-20.38 D,axial length(AL)were from 23.88 to 30.68 mm,and BCVA were from 0.4 to 1.0(decimal notation).Myopia progression of all six eyes slowed down after RLRL therapy.AL in five out of the six eyes shortened-0.07 to-0.63 mm.No side effects were observed.CONCLUSION:Three cases of STL whose progression of myopic shift and AL elongation are successfully reduced and even reversed after RLRL therapy.

Bright Light Treatment of Depression for 28 Adolescents

Background: Bright light therapy, an effective therapeutic option for depressive adults, could provide safe, economic, and effective rapid recovery also in adolescents. Method: This was a randomized cross-over trial, i.e. that 14 patients received first dim white light (50 lux) one hour a day for one week and then Bright light therapy (2500 Lux) for one week. 14 patients received first Bright light therapy and then dim white light. For assessment of depressive symptoms, Beck depression inventory scales were administered 1 week before and one day before dim white light treatment, on the day between dim white light and bright white light treatment, on the day after bright white light treatment and one week after bright white light treatment. Saliva melatonin and cortisol samples were collected at 08:00 a.m. and 08:00 p.m., 1 week before and one day before dim white light treatment, on the day between dim white light and bright white light treatment, on the day after bright white light treatment and one week after bright white light treatment and assayed for melatonin and cortisol to observe any change in circadian timing. Results: 28 volunteers, between 14 and 17 years old, completed the study. Beck depression inventory scores improved significantly. The assays of morning saliva melatonin showed significant differences between Bright white light and dim white light (p = 0.005), those of evening saliva melatonin and saliva cortisol did not show significant differences. No significant adverse reactions were observed. Conclusion: Antidepressant response to bright light treatment in this age group was statistically superior to dim white

Management of sleep disorders among children and adolescents with neurodevelopmental disorders: A practical guide for clinicians

There is a complex relationship between sleep disorders and childhood neurodevelopmental,emotional,behavioral and intellectual disorders(NDEBID).NDEBID include several conditions such as attention deficit/hyperactivity disorder,autism spectrum disorder,cerebral palsy,epilepsy and learning(intellectual)disorders.Up to 75%of children and young people(CYP)with NDEBID are known to experience different types of insomnia,compared to 3%to 36%in normally developing population.Sleep disorders affect 15%to 19%of adolescents with no disability,in comparison with 26%to 36%among CYP with moderate learning disability(LD)and 44%among those with severe LD.Chronic sleep deprivation is associated with significant risks of behavioural problems,impaired cognitive development and learning abilities,poor memory,mood disorders and school problems.It also increases the risk of other health outcomes,such as obesity and metabolic consequences,significantly impacting on the wellbeing of other family members.This narrative review of the extant literature provides a brief overview of sleep physiology,aetiology,classification and prevalence of sleep disorders among CYP with NDEBIDs.It outlines various strategies for the management,including parenting training/psychoeducation,use of cognitive-behavioral strategies and pharmacotherapy.Practical management including assessment,investigations,care plan formulation and follow-up are outlined in a flow chart.

Role of 7-methylxanthine in myopia prevention and control: a mini-review

·Myopia is becoming increasingly common. By 2050 around 10% of the world’s population is expected to be highly myopic(<-5 diopters) and therefore particularly at risk of suffering from sight-threatening complications. Currently used myopia control treatments, such as multifocal soft contact lenses or spectacle lenses, orthokeratology, and atropine eyedrops, either do not completely arrest myopia progression or are associated with significant ocular and possibly systemic side effects. A new candidate for pharmaceutical control of myopia progression and excessive eye elongation, the non-selective adenosine antagonist 7-methylxanthine(7-MX), appears to be nontoxic and effective in reducing myopia progression and axial eye growth in experimental and clinical studies. The latest findings regarding 7-MX for myopia control and evaluate its potential as a supplement to existing treatment options were reviewed.

Perinatally infected adolescents living with human immunodeficiency virus(perinatally human immunodeficiency virus)

The availability of highly potent antiretroviral treatmentduring the last decades has transformed human immunodeficiency virus(HIV) infection into a chronic disease. Children that were diagnosed during the first months or years of life and received treatment, are living longer and better and are presently reaching adolescence and adulthood. Perinatally HIV-infected adolescents(PHIV) and young adults may present specific clinical, behavior and social characteristics and demands. We have performed a literature review about different aspects that have to be considered in the care and follow-up of PHIV. The search included papers in the MEDLINE database via PubM ed, located using the keywords "perinatally HIV-infected" AND "adolescents". Only articles published in English or Portuguese from 2003 to 2014 were selected. The types of articles included original research, systematic reviews, and quantitative or qualitative studies; case reports and case series were excluded. Results are presented in the following topics: "Puberal development and sexual maturation", "Growth in weight and height", "Bone metabolism during adolescence", "Metabolic complications", "Brain development, cognition and mental health", "Reproductive health", "Viral drug resistance" and "Transition to adult outpatient care". We hope that this review will support the work of pediatricians, clinicians and infectious diseases specialists that are receiving these subjects to continue treatment.

Clinical Observation on the Prevention and Treatment of Juvenile Mild Myopia with Traditional Chinese Medicine Comprehensive Therapy

Objective:To observe the clinical effect of traditional Chinese medicine on the prevention and treatment ofjuvenile mild myopia.Methods:One hundred and twenty cases of juvenile mild myopia were randomly divided into six groups,with 20 cases in each group:western medicine group,ultrasonic group,acupuncture group,auricular point group,traditional Chinese oral decoction group,and traditional Chinese medicine comprehensive therapy group.The therapeutic effects of the treatment administered to the six groups were compared.Result:In the post-treatment and follow-up stages,the visual acuity of the traditional Chinese medicine comprehensive therapy group significantly improved along with reduced diopter compared to the other groups(p<0.05).However,the axial length of the six groups had no significant change compared with that before treatment(p>0.05).There were no adverse reactions in any of the patients.Conclusion:In the treatment of juvenile mild myopia,traditional Chinese medicine comprehensive therapy has good therapeutic effect without any adverse reactions;thus,it is worthy of clinical promotion.

少年精神障碍住院患者心理剧治疗效果的定性研究

目的:探讨心理剧治疗对少年精神障碍住院患者的效果。方法:在某医院住院儿童病房招募精神障碍患者22例(年龄12~18岁),根据访谈提纲对连续参加4次心理剧治疗的患者(均按常规服用精神科药物)进行半结构式访谈,采用扎根理论的方法对访谈资料进行深度分析,采用自编心理剧治疗参与感受及评价调查表调查患者参加心理剧治疗后的感受、收获或变化。结果:访谈分析发现,心理剧治疗的效果包括减轻症状、提高自尊程度、促进功能康复和提高社会适应能力4个方面。自编心理剧治疗参与感受及评价调查表结果显示,排名前4位的是促进人际关系、有趣、愿意继续参加和提高自信。结论:心理剧治疗对少年精神障碍住院患者具有辅助治疗作用,可促进自尊水平和社交能力的提升。

舍曲林与认知行为疗法联合治疗青少年抑郁症的效果

目的 探讨分析在青少年抑郁症中联合应用舍曲林与认知行为疗法干预对临床疗效的影响。方法 抽取2020年7月至2023年3月泉州市第三医院接诊的青少年抑郁症患者96例为研究对象,根据就诊挂号顺序将患者分为对照组(单数)和观察组(双数),各48例,给予对照组单独舍曲林干预,给予观察组舍曲林与认知行为疗法联合干预。对两组干预前后的汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、自杀态度量表(QSA)评分进行比较,同时统计两组临床治疗总有效率。结果 干预4周、8周后,两组HAMD、HAMA评分均较干预前降低,且观察组降低幅度比对照组大(P <0.05);干预8周后,两组QSA各维度(对自杀行为性质认知、对自杀者的态度、对自杀家属的态度、对安乐死的态度)评分均较干预前升高,观察组升高幅度比对照组大(P <0.05);观察组临床治疗总有效率95.83%高于对照组81.25%(χ^(2)=5.031,P=5.031)。结论 青少年抑郁症患者中联合应用舍曲林与认知行为疗法干预能够获得理想的干预效果,可减轻其抑郁、焦虑症状程度,扭转其自杀意识。

健康教育联合认知行为干预对青少年抑郁症患者遵医行为及功能失调性认知的影响

目的:探讨健康教育联合认知行为干预(CBT)对青少年抑郁症患者遵医行为及功能失调性认知的影响。方法:研究对象选取2022年7月至2023年10月某院收治的82例青少年抑郁症患者,根据干预方案不同分成对照组(常规药物治疗+健康教育)、干预组(对照组基础上联合CBT)各41例。比较两组患者遵医行为、功能失调性认知水平、抑郁程度及心理弹性、应对方式、社会支持水平。结果:干预后干预组遵医行为评分高于对照组(t=2.051,P<0.05);干预后干预组功能失调性态度量表(DAS)总分低于对照组(t=-11.938,P<0.001);干预后干预组17项汉密尔顿抑郁量表(HAMD-17)评分低于对照组(t=-16.376,P<0.001),康纳·戴维森复原力量表(CD-RISC)“乐观”、“自强”、“坚韧”维度评分高于对照组(t=5.164,5.919,7.544;P<0.001);干预后干预组简易应对方式问卷(SCSQ)的“积极应对”维度得分高于对照组(t=5.354,P<0.001),“消极应对”维度得分低于对照组(t=-3.883,P<0.001);干预后干预组社会支持评定量表(SSRS)“主观支持”和“对社会支持的利用度”维度得分及总分均高于对照组(t=4.520,3.246,5.002;P<0.01)。结论:健康教育联合CBT能有效增强青少年抑郁症患者的遵医行为和心理弹性,改善功能失调性认知水平及应对方式,降低抑郁程度,提高社会支持水平,整体效果良好。

青少年近视患者近视程度与角膜生物力学参数及视网膜微血管指标的相关性分析

目的探讨青少年近视患者的近视程度与角膜生物力学参数及视网膜微血管指标的相关性。方法选取2022年5月至2023年6月于该院眼科就诊的171例(342眼)青少年近视患者作为研究对象,根据等效球镜度(SE)将其分为低度组51例(102眼)、中度组67例(134眼)、高度组53例(106眼)。选取同期该院健康体检者50例(100眼)为对照组。分析SE与各组间角膜生物力学参数、视网膜微血管及黄斑区血流指标的相关性。结果相关性分析结果显示,角膜滞后量(CH)与SE呈正相关(P<0.05);角膜阻力因子(CRF)与SE无明显相关性(P>0.05)。黄斑区整体及内环视网膜浅层毛细血管丛(SCP)血管密度与SE呈正相关(P<0.05);黄斑区中心凹及外环视网膜SCP血管密度与SE无明显相关性(P>0.05);黄斑区整体及外环视网膜深层毛细血管丛(DCP)血管密度与SE呈正相关(P<0.05);黄斑区中心凹及内环视网膜DCP血管密度与SE无明显相关性(P>0.05);黄斑区视网膜浅层毛细血管丛血流密度(SVD)、深层毛细血管丛血流密度(DVD)及中心凹无血管区(FAZ)面积与SE呈正相关(P<0.05)。结论对于青少年近视患者而言,随着近视程度的增加,角膜黏弹性及角膜硬度降低,黄斑区视网膜微血管密度降低,但FAZ面积等相关参数变化尚存争议。光学相干断层扫描血管成像技术对视网膜进行分层定量检测的临床诊疗意义重大。