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[多维家庭治疗与认知行为疗法对大麻使用障碍青少年的影响:一项随机对照研究]

[Multidimensional family therapy and cognitive behavioral therapy in adolescents with a cannabis use disorder: a randomised controlled study].

作者信息

Hendriks V M, van der Schee E, Blanken P

出版信息

Tijdschr Psychiatr. 2013;55(10):747-59.

Abstract

BACKGROUND

More and more adolescents with cannabis problems are seeking treatment at addiction clinics. There is an urgent need for new types of treatment in this field.

AIM

To evaluate the effectiveness of multidimensional family therapy (MDFT) and cognitive behavioral therapy (CBT) in adolescents with a cannabis use disorder.

METHOD

One hundred and nine adolescents were randomly assigned to outpatient MDFT or CBT. Both types of therapy groups had a planned treatment course lasting 5 to 6 months. After 12 months the two groups were compared in terms of changes in cannabis use and in terms of secondary outcome measures, including delinquency.

RESULTS

Adolescents in both treatment groups showed significant and relevant reductions in cannabis use and delinquency over 12 months. Although the MDFT treatment lasted longer and was more intensive than the CBT treatment, there was no difference in the key outcome measures of the treatments. Secondary analyses indicated that older adolescents and those without comorbid psychiatric problems derived considerably more benefit from CBT, whereas younger adolescents and those with comorbid psychiatric problems benefited much more from MDFT.

CONCLUSION

MDFT and CBT are equally effective in reducing cannabis use and delinquent behavior in adolescents with a cannabis use disorder. Age and comorbid psychiatric problems turned out to be important moderators of the treatment results of MDFT and CBT and could therefore be used as a starting point for matching adolescent substance abusers to the most appropriate type of treatment.

摘要

背景

越来越多有大麻问题的青少年在成瘾诊所寻求治疗。该领域迫切需要新型治疗方法。

目的

评估多维家庭治疗(MDFT)和认知行为疗法(CBT)对患有大麻使用障碍青少年的有效性。

方法

109名青少年被随机分配到门诊MDFT组或CBT组。两种治疗组都有一个计划好的为期5至6个月的治疗疗程。12个月后,比较两组在大麻使用变化以及包括犯罪行为在内的次要结果指标方面的情况。

结果

两个治疗组的青少年在12个月内大麻使用和犯罪行为都有显著且相关的减少。尽管MDFT治疗持续时间更长且比CBT治疗更密集,但在治疗的关键结果指标上没有差异。二次分析表明,年龄较大的青少年和没有共病精神问题的青少年从CBT中获益更多,而年龄较小的青少年和有共病精神问题的青少年从MDFT中获益更多。

结论

MDFT和CBT在减少患有大麻使用障碍青少年的大麻使用和犯罪行为方面同样有效。年龄和共病精神问题被证明是MDFT和CBT治疗结果的重要调节因素,因此可以作为为青少年药物滥用者匹配最合适治疗类型的起点。

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