Wood A, Trainor G, Rothwell J, Moore A, Harrington R
Department of Child and Adolescent Psychiatry, Withington Hospital, South Manchester, England.
J Am Acad Child Adolesc Psychiatry. 2001 Nov;40(11):1246-53. doi: 10.1097/00004583-200111000-00003.
To compare group therapy with routine care in adolescents who had deliberately harmed themselves on at least two occasions within a year.
Single-blind pilot study with two randomized parallel groups that took place in Manchester, England. Sixty-three adolescents aged 12 through 16 years were randomly assigned to group therapy and routine care or routine care alone. Outcome data on suicide attempts were obtained without knowledge of treatment allocation on all randomized cases (62/63 by direct interview) on average 29 weeks later. The primary outcomes were depression and suicidal behavior.
In intention-to-treat analyses, adolescents who had group therapy were less likely to be "repeaters" at the end of the study (i.e., to have repeated deliberate self-harm on two or more further occasions) than adolescents who had routine care (2/32 versus 10/31; odds ratio 6.3), but the confidence intervals for this ratio were wide (95% confidence interval 1.4 to 28.7). They were also less likely to use routine care, had better school attendance, and had a lower rate of behavioral disorder than adolescents given routine care alone. The interventions did not differ, however, in their effects on depression or global outcome.
Group therapy shows promise as a treatment for adolescents who repeatedly harm themselves, but larger studies are required to assess more accurately the efficacy of this intervention.
比较团体治疗与常规护理对一年内至少有两次蓄意自伤行为的青少年的效果。
在英国曼彻斯特进行的一项单盲试点研究，设有两个随机平行组。63名年龄在12至16岁之间的青少年被随机分配接受团体治疗与常规护理或仅接受常规护理。在平均29周后，在不知道治疗分配情况的前提下，通过直接访谈获取了所有随机分组病例（62/63）的自杀未遂结果数据。主要结局指标为抑郁和自杀行为。
在意向性分析中，接受团体治疗的青少年在研究结束时成为“重复者”（即再次出现两次或更多次蓄意自伤行为）的可能性低于接受常规护理的青少年（2/32 对比 10/31；优势比6.3），但该比例的置信区间较宽（95%置信区间1.4至28.7）。与仅接受常规护理的青少年相比，他们使用常规护理的可能性也更低，出勤率更高，行为障碍发生率更低。然而，两种干预措施在对抑郁或总体结局的影响方面并无差异。
团体治疗对于反复自伤的青少年显示出有望成为一种治疗方法，但需要更大规模的研究来更准确地评估这种干预措施的疗效。
