Isolan Luciano, Pheula Gabriel, Salum Giovanni Abrahão, Oswald Sylvia, Rohde Luis Augusto, Manfro Gisele Gus
Psychiatry, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
J Child Adolesc Psychopharmacol. 2007 Dec;17(6):751-60. doi: 10.1089/cap.2007.0007.
Social anxiety disorder (SAD) is a highly prevalent and disabling disorder in children and adolescents. This study was designed to evaluate the efficacy and safety of a highly potent and selective serotonin reuptake inhibitor, escitalopram, in the treatment of SAD in children and adolescents. Twenty outpatients with a primary diagnosis of SAD were treated in a 12-week open trial with escitalopram. The primary outcome variable was the change from baseline to end point in Clinical Global Impression-Improvement scale (CGI-I). Secondary efficacy measures included the CGI-Severity scale (CGI-S), the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Screen for Child and Anxiety Related Emotional Disorders (SCARED)-Child and Parent version, and The Youth Quality of Life Instrument-Research Version (Y-QOL-R). On the CGI-I scale, 13 of 20 patients (65%) had a score < or =2, meaning response to treatment. All symptomatic and quality of life measures showed improvements from baseline to week 12, with large effect sizes ranging from 0.9 to 1.9 (all p < 0.001). Escitalopram was generally well-tolerated. These results suggest that escitalopram may be an effective and safe treatment for pediatric SAD. Future double-blind, placebo-controlled, randomized clinical trials are warranted.
社交焦虑障碍（SAD）在儿童和青少年中是一种高度流行且致残的疾病。本研究旨在评估一种高效且选择性的5-羟色胺再摄取抑制剂艾司西酞普兰治疗儿童和青少年SAD的疗效和安全性。20例初步诊断为SAD的门诊患者接受了为期12周的艾司西酞普兰开放试验治疗。主要结局变量是临床总体印象改善量表（CGI-I）从基线到终点的变化。次要疗效指标包括CGI严重程度量表（CGI-S）、儿童社交恐惧症和焦虑量表（SPAI-C）、儿童及与焦虑相关情绪障碍筛查量表（SCARED）儿童版和家长版，以及青少年生活质量量表研究版（Y-QOL-R）。在CGI-I量表上，20例患者中有13例（65%）得分≤2，意味着对治疗有反应。所有症状和生活质量指标从基线到第12周均有改善，效应量范围为0.9至1.9（所有p<0.001）。艾司西酞普兰总体耐受性良好。这些结果表明，艾司西酞普兰可能是治疗儿童SAD的一种有效且安全的疗法。未来有必要进行双盲、安慰剂对照、随机临床试验。
