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青少年重度抑郁症辅助家庭心理教育的一项试点研究:可行性与治疗效果。

A pilot study of adjunctive family psychoeducation in adolescent major depression: feasibility and treatment effect.

作者信息

Sanford Mark, Boyle Michael, McCleary Lynn, Miller Jennifer, Steele Margaret, Duku Eric, Offord David

机构信息

Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Am Acad Child Adolesc Psychiatry. 2006 Apr;45(4):386-495. doi: 10.1097/01.chi.0000198595.68820.10.

Abstract

OBJECTIVE

To obtain preliminary evidence of the feasibility and effectiveness of adjunctive family psychoeducation in adolescent major depressive disorder.

METHOD

Participants were from outpatient clinics in Hamilton and London, Ontario. Over 24 months, 41 adolescents ages 13 through 18 years meeting major depressive disorder criteria were recruited (31 in Hamilton, 10 in London). Participants were randomized to usual treatment or usual treatment plus family psychoeducation. Outcome measures were readministered at 2 weeks, mid-treatment, posttreatment, and 3-month follow-up. Intent-to-treat analyses used chi2 and t tests and growth curve analysis. Standardized effects based on growth curve estimates were calculated for continuous outcomes.

RESULTS

The London site was withdrawn because of poor participant retention. In Hamilton, no participant missed more than one assessment and there was good family psychoeducation adherence. Compared to controls, participants in the experimental group showed greater improvement in social functioning and adolescent-parent relationships (with medium standardized effect size > 0.5), and parents reported greater satisfaction with treatment.

CONCLUSIONS

There were positive treatment effects on family and social functioning processes postulated to mediate the clinical course of major depressive disorder. The study provides support for further evaluation of family psychoeducation in this clinical population.

摘要

目的

获取辅助性家庭心理教育用于青少年重度抑郁症的可行性和有效性的初步证据。

方法

参与者来自安大略省汉密尔顿和伦敦的门诊诊所。在24个月的时间里,招募了41名年龄在13至18岁符合重度抑郁症标准的青少年(汉密尔顿31名,伦敦10名)。参与者被随机分配到常规治疗组或常规治疗加家庭心理教育组。在2周、治疗中期、治疗后和3个月随访时重新进行结果测量。意向性分析采用卡方检验、t检验和生长曲线分析。对连续性结果计算基于生长曲线估计的标准化效应。

结果

由于参与者留存率低,伦敦研究点退出。在汉密尔顿,没有参与者错过超过一次评估,且家庭心理教育依从性良好。与对照组相比,实验组参与者在社会功能和青少年与父母关系方面有更大改善(中等标准化效应量>0.5),并且父母对治疗的满意度更高。

结论

对假定可调节重度抑郁症临床病程的家庭和社会功能过程有积极的治疗效果。该研究为在这一临床人群中进一步评估家庭心理教育提供了支持。

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