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小儿强迫症长期舍曲林治疗后的缓解状态。

Remission status after long-term sertraline treatment of pediatric obsessive-compulsive disorder.

作者信息

Wagner Karen Dineen, Cook Edwin H, Chung Henry, Messig Michael

机构信息

Division of Child and Adolescent Psychiatry, University of Texas Medical Branch, Galveston, Texas 77555, USA.

出版信息

J Child Adolesc Psychopharmacol. 2003;13 Suppl 1:S53-60. doi: 10.1089/104454603322126340.

Abstract

BACKGROUND

Despite its high chronicity, few studies have evaluated the effectiveness of long-term treatment for pediatric obsessive-compulsive disorder (OCD). The goal of the current analysis is to evaluate remission among children and adolescents with OCD treated with sertraline for 12 months.

METHODS

Children (6-12 years old, n = 72) and adolescents (13-18 years old, n = 65) with Diagnostic and Statistical Manual of Mental Disorders (third edition, revised) OCD, who had completed a 12-week, double-blind, placebo-controlled sertraline study, were administered open-label sertraline 50-200 mg for 52 weeks. Full remission was defined by a Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) score of 8 or less, and partial remission was defined as a CY-BOCS score of 15 or less.

RESULTS

Using an last observation carried forward analysis, 47% of patients achieved a full remission, and an additional 25% achieved a partial remission. Among study completers, full remission was achieved by 55% of patients and partial remission by 31%. Two thirds of patients with severe OCD at baseline (CY-BOCS of 26 or greater) achieved full or partial remission. Children were more likely to achieve a full remission than adolescents.

CONCLUSION

Sertraline is effective in the treatment of childhood and adolescent OCD, with initial acute response converting to remission and improved functional status in a substantial proportion of patients. More research is needed to develop pharmacologic and psychotherapeutic strategies that facilitate the achievement of full remission in the remaining patients suffering from this chronic and disabling illness.

摘要

背景

尽管儿童强迫症(OCD)具有高度慢性化特点,但很少有研究评估其长期治疗的有效性。本分析的目的是评估接受舍曲林治疗12个月的儿童和青少年强迫症患者的缓解情况。

方法

患有《精神疾病诊断与统计手册》(第三版,修订版)强迫症的儿童(6 - 12岁,n = 72)和青少年(13 - 18岁,n = 65),他们完成了一项为期12周的双盲、安慰剂对照舍曲林研究,随后接受50 - 200 mg开放标签舍曲林治疗52周。完全缓解定义为儿童耶鲁-布朗强迫症量表(CY - BOCS)评分≤8分,部分缓解定义为CY - BOCS评分≤15分。

结果

采用末次观察结转分析,47%的患者实现完全缓解,另有25%的患者实现部分缓解。在完成研究的患者中,55%的患者实现完全缓解,31%的患者实现部分缓解。基线时患有重度强迫症(CY - BOCS≥26分)的患者中有三分之二实现了完全或部分缓解。儿童比青少年更有可能实现完全缓解。

结论

舍曲林对儿童和青少年强迫症有效,初始急性反应可转化为缓解,且相当比例的患者功能状态得到改善。需要开展更多研究来制定药物和心理治疗策略,以促进其余患有这种慢性致残性疾病的患者实现完全缓解。

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