Rynn M A, Siqueland L, Rickels K
Mood and Anxiety Disorders Section, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.
Am J Psychiatry. 2001 Dec;158(12):2008-14. doi: 10.1176/appi.ajp.158.12.2008.
The study compared the safety and efficacy of sertraline, a selective serotonin reuptake inhibitor, and placebo in the treatment of generalized anxiety disorder in children and adolescents.
The study subjects were 22 children and adolescents age 5-17 years who met the DSM-IV criteria for generalized anxiety disorder according to the Anxiety Disorders Interview Schedule for Children-Revised and who had a Hamilton Anxiety Rating Scale score > or = 16. The patients underwent a 2-3-week prestudy evaluation period, followed by a 9-week double-blind treatment phase in which they were randomly assigned in blocks of four to receive either sertraline or pill placebo. The maximum dose of sertraline was 50 mg/day. Primary outcome measures were the Hamilton anxiety scale and the Clinical Global Impression scale.
The Hamilton anxiety scale total score, psychic factor, and somatic factor and the Clinical Global Impression severity and improvement scales showed significant differences with treatment in favor of sertraline over placebo beginning at week 4. Self-report measures reflected these results at the end of treatment.
The results of this double-blind, placebo-controlled trial suggest that sertraline at the daily dose of 50 mg is safe and efficacious for the treatment of generalized anxiety disorder in children and adolescents.
本研究比较了选择性5-羟色胺再摄取抑制剂舍曲林与安慰剂治疗儿童及青少年广泛性焦虑症的安全性和疗效。
研究对象为22名年龄在5至17岁之间、根据修订版儿童焦虑症访谈量表符合《精神疾病诊断与统计手册》第四版广泛性焦虑症标准且汉密尔顿焦虑量表评分≥16分的儿童及青少年。患者先经历2至3周的研究前评估期,随后进入为期9周的双盲治疗阶段,在此期间他们被按每组4人进行随机分组,分别接受舍曲林或丸剂安慰剂治疗。舍曲林的最大剂量为50毫克/天。主要疗效指标为汉密尔顿焦虑量表和临床总体印象量表。
从第4周开始,汉密尔顿焦虑量表总分、精神因子、躯体因子以及临床总体印象严重程度和改善程度量表显示,与安慰剂相比,舍曲林治疗组有显著差异。自我报告指标在治疗结束时也反映出了这些结果。
这项双盲、安慰剂对照试验的结果表明,每日剂量为50毫克的舍曲林治疗儿童及青少年广泛性焦虑症安全有效。