An Intervention Study of Language Cognition and Emotional Speech Community Method for Children’s Speech Disorders

Speech disorders are a common type of childhood disease.Through experimental intervention,this study aims to improve the vocabulary comprehension levels and language ability of children with speech disorders through the language cognition and emotional speech community method.We also conduct a statistical analysis of the inter-ventional effect.Among children with speech disorders in Dongguan City,224 were selected and grouped accord-ing to their receptive language ability and IQ.The 112 children in the experimental group(EG)received speech therapy with language cognitive and emotional speech community,while the 112 children in the control group(CG)only received conventional treatment.After six months of experimental intervention,the Peabody Picture Vocabulary Test-Revised(PPVT-R)was used to test the language ability of the two groups.Overall,we employed a quantitative approach to obtain numerical values,examine the variables identified,and test hypotheses.Further-more,we used descriptive statistics to explore the research questions related to the study and statistically describe the overall distribution of the demographic variables.The statistical t-test was used to analyze the data.The data shows that after intervention through language cognition and emotional speech community therapy,the PPVT-R score of the EG was significantly higher than that of the CG.Therefore,we conclude that there is a significant difference in language ability between the EG and CG after the therapy.Although both groups improved,the post-therapy language level of EG is significantly higher than that of CG.The total effective rate in EG is higher than CG,and the difference is statistically significant(p<0.05).Therefore,we conclude that the language cogni-tion and emotional speech community method is effective as an interventional treatment of children’s speech dis-orders and that it is more effective than traditional treatment methods.

Central choroidal thickness in children and adolescents with anxiety disorders:enhanced depth imaging optical coherence tomography findings

AIM:To measure the central choroidal thickness(ChT)in children and adolescents with anxiety disorders.METHODS:Totally 41 anxiety patients(8-16 y)and 35 healthy controls(age-matched)were evaluated.Complete ophthalmic examination was performed.Inclusion criteria were best corrected visual acuity≥20/20,normal intraocular pressure(IOP;10-21 mm Hg),and no systemic or ocular diseases according to history.The diagnosis of psychiatric disorders was determined using Schedule for Affective Disorders and Schizophrenia for School Aged Children Present-Lifetime Version(K-SADS-PL).Enhanced depth imaging optical coherence tomography(EDI-OCT)was used to measure the central ChT.RESULTS:The mean age was 12.18±3.24 y in the patient group and 12.86±3.15 y in the control group.Age and gender distribution of the two groups was similar.Central ChT mean value was 353.26±31.9μm in anxiety patients while 318.75±60.9μm in the control group.Mean central ChT was statistically significantly higher in the children and adolescents with anxiety disorders than healthy controls(P=0.002).CONCLUSION:The children and adolescents with anxiety disorders have significantly thicker central ChT than controls.In the larger sample,longitudinal studies will contribute to the use of choroidal differences as a clinical marker for monitoring anxiety disorders.

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.

Socio-Demographic,Biopsychosocial and Lifestyle Behaviors Related with Eating Disorders of Children and Adolescents of Costa Rica

The objective of the study was to evaluate the association of sociodemographic, biopsychosocial and lifestyle behaviors (diet, sedentarism and physical activity) with eating disorders (ED) in a national sample of Costa Rican children and adolescents. This was a cross-sectional and descriptive study. A total of 2667 students of elementary, middle and high school from sixty-four educative centers (40 schools and 24 high schools) of Costa Rica participated in the study. The predictive factors associated with ED are: body image dissatisfaction (β = 0.367;p β = 0.131;p β = 0.109;p 0.001), intentionally hurt or harm itself (β = 0.074;p β = 0.053;p β = 0.052;p β = 0.051;p β = -0.071;p β = -0.068;p = 0.010) and the age (β = -0.064;p = 0.001) are not related with the development of ED. Psychosocial factors (body image dissatisfaction and intentionally self-injure) had the greatest influence (near 27%) of the global variance of the regression model that explained the association with ED. Programs should be promoted to monitor children and adolescents with excess weight, as well as, the coexistence of erroneous weight and body image perceptions in these population. This could protect against the development of ED in children and adolescents. Evidence-Based Medicine: Level V of evidence (descriptive study).

Internet Gaming Disorder and Mental Health of Children in China:A Latent Profile Analysis

In recent years,speculation of an increase in Internet Gaming Disorder(IGD)has surfaced with the growing popularity of internet gaming among Chinese children and adolescents.The detrimental impact of IGD on mental health cannot be denied,even though only a small portion of the screen-dependent population exhibits psychopathological and behavioral symptoms.The present study aimed to explore a latent profile analysis(LPA)of Internet Gaming Disorder on the mental health of Chinese school students.The data were collected from a sample of 1005 Chinese school students(49.8%male;age M=13.32,SD=1.34 years)using a paper-pencil survey through convenience sampling.LPA explored three latent profiles of internet gamers:regular gamers(62.4%),moderate gamers(28.1%),and probable disordered gamers(9.4%).Results showed that the probable disordered gamers had significantly higher levels of depression,anxiety,emotional and conduct problems,hyperactivity,and peer problem symptoms as well as lower life satisfaction,and pro-social symptoms compared to regular and moderate gamers(p<0.05).This study would be helpful to mental health professionals in designing interventions for gamers who present IGD symptoms.Future longitudinal studies should also be undertaken to assess whether mental health worsens for probable disordered gamers.

Epidemiology of functional gastrointestinal disorders in children and adolescents: A systematic review

To assess the prevalence of functional gastrointestinal disorders (FGIDs) in children and adolescents.METHODSPubMed, EMBASE, and Scopus databases were searched for original articles from inception to September 2016. The literature search was made in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. For inclusion, each study had to report epidemiological data on FGIDs in children between 4 and 18 years old and contain standardized outcome based on Rome II, III or IV criteria. The overall quality of included epidemiological studies was evaluated in accordance with Loney’s proposal for prevalence studies of health literature. Two reviewers assessed each study for data inclusion and extraction. Discrepancies were reconciled through discussion with seniors.RESULTSA total of 659 articles were identified from the databases and 16 through manual search. A total of 43 articles fulfilled the eligibility criteria for full-text reading, with 26 remaining to be included in the final analysis. All studies were written in English and published between 2005 and 2016. Eight (30.8%) articles were performed in North America, five (19.2%) in Latin America, five (19.2%) in Europe, seven (27%) in Asia, and one (3.8%) in Africa. Sample size varied between 114 and 99416 subjects, totaling 132600 individuals. Fourteen (53.9%) studies recruited their target samples from schools, 11 (42.3%) from healthcare settings and the remaining one (3.8%) from online panel community. The overall FGID prevalence rates for student samples ranged from 9.9% to 29% to as high as 87% in clinical samples. Cyclic vomiting, irritable bowel syndrome and functional constipation were the most researched conditions, with a prevalence ranging from 0.2% to 6.2%, 0% to 45.1% and 0.5% to 86.9%, respectively. The qualitative appraisal revealed that most of the studies showed average or below average generalizability.CONCLUSIONThe heterogeneity of the studies on FGIDs must be improved in order to allow comparison. Improvements should include appropriate sampling of representative population, comparable study setting, and consistent data collection.

Review of the genetic basis of emotion dysregulation in children and adolescents

Previous evidence suggests that emotion dysregulation may have different biological correlates between adults and children/adolescents. Although the role of genetic factors has been extensively studied in adult-onset emotion dysregulation, the genetic basis for pediatriconset emotion dysregulation remains elusive. The current review article presents a summary of previous studies that have suggested a few genetic variants associated with pediatric emotion dysregulation. Among these candidate loci, many prior studies have been focused on serotonin transporter promoter gene polymorphism 5-HTTLPR. Certain alleles of the 5-HTTLPR gene polymorphism have been found to be associated with traits associated with emotion dysregulation, such as aggression, affect reactivity, and insecure attachment. Additionally, genetic variants involving dopamine and neurophysiological biomarkers like the COMT Val158Met(rs460) and dopamine receptor D2/ ankyrin repeat and kinase domain containing one polymorphisms may play a role in emotion dysregulation. Inconsistent findings have been noted, possibly due to the heterogeneity in study designs and characteristics of different populations. Further research on the role of genetic predetermination of emotion dysregulation in children and adolescents is warranted.

Motor abilities of children and adolescents with a psychiatric condition:A systematic literature review

AIM: To summarize research regarding the motor abilities of children and adolescents who suffer from a common psychiatric condition.METHODS: In order to outline the current knowledge regarding the motor abilities of children and adolescents with autism spectrum disorders(ASD), attention deficit hyperactivity disorder(ADHD), disruptive behavior disorders(DBD) and depression, a comprehensive systematic literature search was carried out using Pub Med, Medline and ERIC databases. The databases were searched for relevant English language articles published between January 1990 and April 2014. Only studies that conducted a quantitative evaluation of motor ability and concerned individuals aged 0-18 years were included. A separate search was conducted for each disorder(ASD, ADHD, DBD, depression) in conjunction with each of the following keywords:(psycho/perceptuo) motor/movement skill(s),(psycho/perceptuo) motor/movement abilities,(psycho/perceptuo) motor/movement impairment,(psycho/perceptuo) motor/movement problem(s), motor function, motor coordination, motor performance, motor deficit(s). To detect supplementary relevant literature, the reference lists of the retrieved articles were examined. RESULTS: The search strategy yielded 51 studies meeting the inclusion criteria. In total, 28 studies were included that examined the motor abilities of children and adolescents with ASD. All studies indicated that they performed below average on various standardized motor assessment instruments. The overall prevalence rate for impairment in motor abilities ranged from 33% to 100%. Twenty-seven studies examined the motor abilities of children and adolescents with ADHD. Depending on the type of motor assessment tool and the cut-off points used by different researchers, prevalence rates of impairment in motor abilities are highly variable and ranged from 8% to 73%. Remarkably, there is a paucity of research addressing the motor abilities of individuals with DBD or depression. Furthermore, methodological problems, such as measurement and comorbidity issues, complicate the generalization of the findings. CONCLUSION: Research suggests that motor impairment is highly prevalent in some psychiatric conditions, particularly ASD and ADHD. However, future work is necessary to draw sound conclusions.

Classification,prevalence and integrated care for neurodevelopmental and child mental health disorders:A brief overview for paediatricians

‘Neurodevelopmental disorders’comprise a group of congenital or acquired longterm conditions that are attributed to disturbance of the brain and or neuromuscular system and create functional limitations,including autism spectrum disorder,attention deficit/hyperactivity disorder,tic disorder/Tourette’s syndrome,developmental language disorders and intellectual disability.Cerebral palsy and epilepsy are often associated with these conditions within the broader framework of paediatric neurodisability.Co-occurrence with each other and with other mental health disorders including anxiety and mood disorders and behavioural disturbance is often the norm.Together these are referred to as neurodevelopmental,emotional,behavioural,and intellectual disorders(NDEBIDs)in this paper.Varying prevalence rates for NDEBID have been reported in developed countries,up to 15%,based on varying methodologies and definitions.NDEBIDs are commonly managed by either child health paediatricians or child/adolescent mental health(CAMH)professionals,working within multidisciplinary teams alongside social care,education,allied healthcare practitioners and voluntary sector.Fragmented services are common problems for children and young people with multi-morbidity,and often complicated by subthreshold diagnoses.Despite repeated reviews,limited consensus among clinicians about classification of the various NDEBIDs may hamper service improvement based upon research.The recently developed“Mental,Behavioural and Neurodevelopmental disorder”chapter of the International Classification of Diseases-11 offers a way forward.In this narrative review we search the extant literature and discussed a brief overview of the aetiology and prevalence of NDEBID,enumerate common problems associated with current classification systems and provide recommendations for a more integrated approach to the nosology and clinical care of these related conditions.

MDT模式在门诊情绪障碍患儿中的应用

目的 探讨多学科协作诊疗(multidisciplinary diagnosis and treatment, MDT)模式在儿童门诊情绪障碍患儿中的应用效果。方法 在MDT模式下,收集2021年6月至2022年12月门诊就诊的32例情绪障碍患儿作为观察组,遵从患者意愿将常规模式下2020年11月至2021年5月门诊就诊的68例患儿作为对照组。比较2组人均诊断、检查、缴费、门诊停留时间,并对痊愈率、满意度、重复事件发生率进行比较。结果 观察组患儿人均诊断、检查、缴费、门诊停留时间较对照组明显缩短,差异有统计学意义(P<0.001);重复事件发生率明显低于对照组,差异有统计学意义(χ^(2)=12.337,P=0.001);痊愈率明显高于对照组,效果不明显率低于对照组,差异有统计学意义(χ^(2)=7.449,P=0.014);就诊满意度明显高于对照组,差异有统计学意义(χ^(2)=11.313,P=0.01)。结论 MDT模式简化了儿童门诊情绪障碍患儿就诊流程,降低了就诊过程中重复就诊、门诊误诊、漏诊发生率,可明显提高就诊效率、患者满意度和就诊依从性,有利于情绪障碍患儿的早发现、早诊断、早治疗,能够避免此类患儿因漏诊延误治疗带来的伤害。

儿童青少年精神障碍患者家长自杀倾向及危险因素分析

目的探讨儿童青少年精神障碍患者家长自杀倾向及其危险因素,并构建自杀倾向的预测模型。方法采用横断面调查的方法,收集2022年8月至2023年7月就诊于安徽省内两所医院共299名儿童青少年精神障碍家长的社会人口学资料,并采用自杀相关的标准化问题、患者健康问卷-9(PHQ-9)以及多伦多述情障碍量表(TAS-20)分别评估调查对象自杀倾向、抑郁症状及述情障碍的程度。结果自杀倾向的总体检出率为15.4%,其中自杀意念、自杀计划和自杀未遂检出率分别为11.0%、3.3%和8.0%。Logistic回归分析结果显示,躯体疾病史、抑郁症状、述情障碍以及情感辨别不能因子与较高的自杀倾向风险有关(均P<0.05)。基于回归分析结果,构建预测患儿家长自杀倾向风险预测模型,并绘制受试者工作特征(ROC)曲线下面积(AUC)为0.80(95%CI:0.72~0.87,P<0.05)。结论儿童青少年精神障碍患者家长自杀倾向检出率较高,提示临床上在注重青少年精神障碍患者的同时,亦不能忽视患儿家长的心理健康,应加强对患儿和家长的护理,必要时应提供个体化的综合干预措施。

屏幕暴露与学龄前孤独症谱系障碍儿童情绪行为问题相关性研究

背景既往已有多项研究证实屏幕暴露现象在学龄前儿童中普遍存在,并且与儿童情绪行为问题相关,现有研究多集中在正常学龄前儿童,有关屏幕暴露与学龄前孤独症谱系障碍(ASD)儿童情绪行为问题相关的研究较为罕见。目的 调查学龄前ASD儿童屏幕暴露情况及情绪行为问题异常检出情况,探究屏幕暴露与学龄前ASD儿童情绪行为问题有无相关。方法 选择2022年2—8月在郑州大学第三附属医院儿童发育行为科就诊的符合《精神障碍诊断和统计手册》(DSM-V)孤独症诊断标准的ASD学龄前儿童为ASD组,同期选取郑州市某幼儿园正常发育儿童为对照组。由两组儿童主要照护人进行填写屏幕暴露问卷及长处与困难问卷(家长版)。结果 两组儿童屏幕接触时间、家长对屏幕管理、“屏幕剥夺”反应比较,差异无统计学意义(P<0.001);ASD组儿童亲社会行为、困难总分及各个分维度(情绪症状、品行问题、多动/注意缺陷问题、同伴交往问题)异常检出率均高于对照组(P<0.001);Logistic回归分析发现电子设备放置在睡觉或玩耍空间、观看时照护人是否互动讲解、照护人对孩子观看电子屏幕态度、接触电子屏幕是主动要求还是被动参与、强制关掉电子屏幕孩子反应是学龄前ASD儿童情绪行为问题的影响因素(P<0.05)。结论 屏幕暴露可能对ASD儿童情绪行为问题产生影响,家长应合理管理学龄前ASD儿童屏幕使用。

孤独症谱系障碍和精神分裂症青少年的面部表情识别能力

目的:探讨孤独症谱系障碍、精神分裂症青少年的面部表情识别能力特点。方法:入组12~18岁孤独症谱系障碍患者77例、精神分裂症患者67例及年龄相匹配的正常发育青少年68例,完成面部表情识别任务测查。结果:孤独症谱系障碍组基础面部表情识别任务总分低于精神分裂症组及正常发育组(Ps<0.05),精神分裂症组和正常发育组间无统计学差异(P>0.05);孤独症谱系障碍组和精神分裂症组间复杂表情识别任务总分差异无统计学意义(P>0.05),但两组均低于正常对照组(均P<0.001)。结论:孤独症谱系障碍和精神分裂症青少年均存在面部表情识别缺陷,孤独症谱系障碍表现为基础和复杂面部表情识别缺陷,而精神分裂症表现为复杂面部表情识别缺陷。

精神科医师对MECT应用于儿童与青少年精神障碍患者的认知情况调查

目的调查精神科医师对无抽搐电休克治疗(MECT)应用于儿童与青少年精神障碍患者的认知情况。方法采用一般资料调查表、MECT的基本知识和经验调查问卷、对儿童与青少年精神障碍患者应用MECT的经验和知识调查问卷、对儿童与青少年患者应用MECT疗效和不良反应认知情况调查问卷、对儿童与青少年精神障碍患者应用MECT态度调查问卷调查中原地区63家医院的138名精神科医师对MECT应用儿童与青少年精神障碍患者的认知情况。结果不同级别医院精神科医师在有MECT相关基本知识方面,未给所管理的患者做过MECT应用、如何评估自己对于患者应用MECT的知识方面,MECT对患者记忆力有无长期不良影响、MECT对患者注意力和专注力有无长期不良影响的认知方面,具有严重精神障碍的青少年(13~17岁)使用MECT方面的比较,差异均有统计学意义(P<0.05或0.01)。结论不同级别医院精神科医师对MECT应用于儿童与青少年精神障碍患者的认知和使用方面,均存在差异,有必要建立区域性或全国性MECT数据中心,制定MECT指南,为儿童与青少年精神障碍的治疗提供指导。

叙事暴露疗法在儿童和青少年创伤后应激障碍患者中应用效果的Meta分析

背景叙事暴露疗法(NET)结合叙事疗法和暴露疗法的优点,对缓解创伤后应激障碍(PTSD)症状有效,有助于患者对创伤进行深入的认识,也具有较好的安全性。儿童和青少年是PTSD的高发人群,但NET对该人群干预效果的研究结果存在差异。目的系统评价NET对儿童和青少年PTSD患者的干预效果,为NET的临床应用提供参考。方法于2022年8月1日,计算机检索Cochrane Library、PubMed、Web of Science、CINAHL、中国知网(CNKI)、中国生物医学文献数据库(SinoMed)、维普数据库和万方数据库,检索时限为建库至2022年6月。采用主题词与自由词相结合的方式进行检索,收集NET治疗儿童和青少年PTSD的文献。根据Cochrane协作网更新的偏倚风险评估手册中对随机对照试验的真实性评价标准(2011),评价文献质量。采用RevMan 5.4对纳入的随机对照试验进行Meta分析。结果纳入9篇文献,共包括394例儿童和青少年PTSD患者。Meta分析结果显示,在PTSD症状缓解程度方面,干预后1~3个月(SMD=0.22,95%CI:-0.84~1.28)以及干预后6个月(SMD=0.21,95%CI:-0.75~1.17),NET与放松疗法的效果比较,差异无统计学意义;干预后1~3个月(SMD=-0.66,95%CI:-1.04~-0.27)以及干预后6个月(SMD=-0.77,95%CI:-1.36~-0.19),NET的效果均优于常规治疗,差异均有统计学意义。在抑郁症状缓解程度方面,治疗后1~3个月,NET与常规治疗的效果比较,差异无统计学意义(SMD=-0.39,95%CI:-0.98~0.21);干预后6个月,NET与常规治疗的效果比较,差异无统计学意义(SMD=-0.74,95%CI:-2.23~0.75)。在心理困扰缓解程度方面,干预后1~3个月,NET与常规治疗的效果比较,差异无统计学意义(SMD=-0.54,95%CI:-2.14~1.07)。在食欲亢进缓解程度方面,NET与常规治疗的效果比较,差异无统计学意义(SMD=-0.17,95%CI:-0.54~0.19)。结论与常规治疗相比,NET对缓解儿童和青少年PTSD症状的效果更佳,且具有中长期效果,但在改善抑郁症状、心理困扰以及食欲亢进方面无明显优势。

儿童青少年精神障碍照料者负担现状及影响因素研究进展

对儿童青少年精神障碍照料者负担现状、影响因素进行综述,以期为我国儿童青少年精神障碍照料者负担的相关因素及干预措施研究提供方向。

生活技能训练联合情感技能训练预防青少年抑郁障碍非自杀性自伤行为及改善手机社交媒体依赖的价值

目的:探讨生活技能训练(living skill training,LST)联合情感技能训练(emotional skill training,EST)预防青少年抑郁障碍非自杀性自伤(non-suicidal self-injury,NSSI)行为及改善手机社交媒体依赖的价值。方法:纳入2020年1月至2022年12月就诊于本院的青少年抑郁障碍患者143例,按照护理方案分为观察组(n=57)和对照组(n=86),观察组予LST联合EST护理,对照组予LST护理,对比护理前后自我伤害行为量表评分、手机社交媒体依赖评分及纽卡斯尔护理满意度量表评分并分析。结果:护理后,两组忧郁孤独、攻击违纪、自残、退缩与自我批评评分及总分均下降,且观察组忧郁孤独、攻击违纪、自残、退缩与自我批评评分及总分均低于对照组,差异均有统计学意义(P均<0.05);两组突显性、社交增益、强迫性、冲突性及戒断性评分均下降,且观察组突显性、社交增益、强迫性及戒断性评分均低于对照组,差异均有统计学意义(P均<0.05);两组关心与爱护、技术与责任、指导与支持评分及总分上升,且观察组关心与爱护、技术与责任、指导与支持评分及总分均高于对照组,差异均有统计学意义(P均<0.05)。结论:LST联合EST可改善青少年抑郁障碍状和手机社交媒体依赖情况,预防NSSI行为。

青少年亲子依恋、情绪调节对抑郁的影响

目的探讨亲子依恋、情绪调节策略与抑郁的关系。方法选取芜湖市第四人民医院三个开放病区的住院青少年抑郁障碍患者63人作为研究组,选取67名健康青少年作为对照组。研究组和对照组均施测父母同伴依恋量表(Inventory of Parent and Peer Attachment,IPPA)中的父母分量表评估亲子依恋,情绪调节策略量表(Emotion Regulation Questionnaire,ERQ)评估情绪调节策略的使用,抑郁自评量表(Self-Rating Depression Scale,SDS)评估抑郁情绪。采用独立样本T检验对比研究组与健康组各量表得分的差异,采用多元线性回归分析亲子依恋、情绪调节策略对抑郁的影响。结果研究组亲子依恋、认知重评策略得分显著低于对照组而表达抑制、抑郁得分显著高于对照组。无论是研究组还是对照组,母子依恋得分显著高于父子依恋(t=2.76,P=0.01)。亲子依恋、认知重评预测抑郁的主效应显著(t=-3.32,P<0.001,t=-4.57,P<0.001),交互效应不显著(t=-0.08,P>0.05)。结论青少年抑郁障碍患者亲子依恋、情绪调节策略、抑郁情绪得分与对照组相比差异显著。亲子依恋、认知重评均负向预测抑郁情绪。

虚拟与增强现实对孤独症谱系障碍儿童青少年认知、情绪和适应性行为干预效果的系统综述

目的 系统分析虚拟现实技术(VR)与增强现实技术(AR)对孤独症谱系障碍(ASD)儿童认知、情绪以及适应性行为的干预效果。方法 采用主题词检索法对PubMed、Cochrane Library、Embase、Web of Science、中国知网、维普、万方数据库进行检索,检索时限为2008年1月至2024年8月,选择主题为VR或AR干预ASD儿童青少年认知、情绪及适应性行为的随机对照试验(RCT),进行系统综述。结果 最终纳入9项RCT,来自中国、意大利、西班牙、伊朗、英国5个国家,涉及384例参与者,发表时间在2016年至2024年。研究对象年龄2~15岁。干预技术包括VR沉浸式头盔、Xbox 360 Kinect游戏控制台、CAVE式沉浸式虚拟环境、AR。干预内容为基于VR与AR的日常生活场景体验,认知、社交情景训练,情绪识别任务等。结局指标包括高水平认知功能、情感功能、注意力、记忆力、基本人际交往、适应性行为。干预频率通常为每次15~60 min,每周1~3次,共3~24周。基于VR的训练提高整体认知、情绪识别准确率、情绪控制与表达、基本人际交往和适应性行为;AR训练提高执行功能、空间定位能力、完成任务的专注度和记忆力。结论 VR与AR有助于提高ASD儿童青少年的整体认知功能、情感功能、注意力、记忆力,改善基本人际交往和适应性行为。

氟伏沙明联合认知行为疗法治疗儿童青少年情绪障碍的疗效观察

目的分析氟伏沙明联合认知行为疗法治疗儿童青少年情绪障碍的疗效。方法将2020年1月至2022年12月新疆医科大学第一附属医院儿童青少年情绪障碍患儿(100例)设置为研究对象,按照随机单双数抽签法分组(抽到单数入对照组、抽到双数入研究组),各50例,对照组应用单一氟伏沙明治疗,研究组采取氟伏沙明+认知行为疗法治疗。比较两组治疗前后儿童抑郁障碍自评量表(DSRSC)评分、儿童焦虑性情绪障碍筛查表(SCARED)评分、儿童大体评定量表(CGAS)评分及儿童青少年生活质量量表(QLSCA)评分。结果治疗前两组DSRSC、SCARED评分对比差异无统计学意义(P>0.05),治疗后两组DSRSC、SCARED评分较治疗前均降低,且研究组评估分值低于对照组,差异均有统计学意义(P<0.05);治疗前两组CGAS评分对比差异无统计学意义(P>0.05),治疗后两组CGAS评分较治疗前均升高,且研究组评估分值高于对照组,差异均有统计学意义(P<0.05);治疗前两组QLSCA各维度评分对比差异无统计学意义(P>0.05),治疗后两组QLSCA各维度评分较治疗前均升高,且研究组评估分值高于对照组,差异均有统计学意义(P<0.05)。结论儿童青少年情绪障碍采用氟伏沙明+认知行为治疗可取得较理想的抗焦虑、抗抑郁的治疗效果,同时可提升生活质量,值得应用。