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基于社区的临床实践中儿童强迫症的认知行为治疗:临床意义及与疗效的基准比较。

Cognitive-behavioral treatment of childhood obsessive-compulsive disorder in community-based clinical practice: clinical significance and benchmarking against efficacy.

机构信息

Griffith Institute of Health and Medical Research, Behavioral Basis of Health, Griffith University, Gold Coast Campus, Brisbane, Queensland 4222, Australia.

出版信息

Behav Res Ther. 2010 May;48(5):409-17. doi: 10.1016/j.brat.2010.01.004. Epub 2010 Feb 2.

Abstract

OBJECTIVE

To evaluate the feasibility and outcomes of evidence-based (EB) manualized, cognitive-behavioral treatment (CBT) for childhood obsessive-compulsive disorder (OCD), when delivered in an outpatient community-based specialist clinic.

METHOD

This study, conducted in an outpatient private clinic in South-East Queensland Australia, involved thirty-three children and adolescents with OCD. Children were assessed at pre- and post-treatment, by means of diagnostic interviews, symptom severity interviews, and self-report. Treatment involved 12 sessions CBT delivered either individually or in small groups and included parental involvement.

RESULTS

Manualized CBT could be transported to the community setting effectively, with 63% of the current sample responding positively, based on post-treatment diagnosis. Significant change was evident across a wide-range of outcomes; including, diagnostic severity, symptom severity, child reported depression and anxiety, and both child and parent reported OCD functional impairment.

CONCLUSIONS

This study provides evidence for the transportability of manualized CBT in clinical community practice for pediatric OCD. The next important step is larger community based dissemination and effectiveness studies to advance both research and clinical practice outcomes.

摘要

目的

评估基于循证(EB)的、认知行为治疗(CBT)在社区门诊专科诊所治疗儿童强迫症(OCD)的可行性和效果。

方法

本研究在澳大利亚昆士兰州东南部的一家社区门诊私人诊所进行,涉及 33 名患有 OCD 的儿童和青少年。通过诊断访谈、症状严重程度访谈和自我报告,在治疗前和治疗后对儿童进行评估。治疗包括 12 次 CBT 治疗,个体治疗或小组治疗,包括家长参与。

结果

基于治疗后的诊断,有 63%的当前样本显示出积极的反应,表明 CBT 可以有效地转移到社区环境中。在包括诊断严重程度、症状严重程度、儿童报告的抑郁和焦虑以及儿童和家长报告的 OCD 功能障碍在内的广泛结果中都出现了显著变化。

结论

本研究为儿科 OCD 的临床社区实践中 CBT 的可转移性提供了证据。下一步是进行更大规模的基于社区的推广和有效性研究,以推进研究和临床实践的结果。

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