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基于家庭的认知行为干预对肥胖儿童(7-13 岁)体重指数、自尊和抑郁症状的影响:一项随机等待名单对照试验。

Effect of a family-based cognitive behavioural intervention on body mass index, self-esteem and symptoms of depression in children with obesity (aged 7-13): a randomised waiting list controlled trial.

机构信息

Faculty of Psychology, University of Bergen, Cristiesgt. 12, NO-5020 Bergen, Norway.

Norwegian Competence Centre for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.

出版信息

Obes Res Clin Pract. 2013 Mar-Apr;7(2):e116-e128. doi: 10.1016/j.orcp.2012.06.003.

Abstract

OBJECTIVE

We examined the effect of a 12-week family-based cognitive behavioural weight management programme developed for use in primary care settings.

METHODS

The sample consisted of 49 children with obesity (aged 7-13 years; mean ± SD: 10.68 ± 1.24). Families were randomly assigned to immediate start-up of treatment or to a 12-week waiting list condition. Outcome measures were body mass index standard deviation score (BMI SDS), self-esteem, symptoms of depression and blood parameters indicative of cardio-metabolic risk. Assessments were conducted at baseline, post-treatment, post-waiting list and 12 months after treatment termination.

RESULTS

The mean reduction for the treatment group was -0.16 BMI SDS units compared with an increase of 0.04 units for the waiting list group (p = .001). For the entire sample, there was a significant post-treatment improvement on BMI SDS (p = .001), all self-esteem measures (p = .001-.041) and symptoms of depression (p = .004). The mean BMI SDS reduction was -0.18 units post-treatment, and it was maintained at 12-month follow-up. Significant reductions were found in blood lipid levels of total cholesterol (p = .03), LDL-cholesterol (p = .005) and HDL-cholesterol (p = .01) at 12-month follow-up. The favourable effect on most of the psychological measures waned from post-treatment to follow-up, but not approaching baseline levels. Boys demonstrated significantly greater reductions in BMI SDS than girls (p = .001), while baseline psychiatric co-morbidity did not influence BMI SDS outcome.

CONCLUSIONS

The treatment shows significant and favourable effects on BMI SDS, self-esteem and symptoms of depression compared with a waiting list condition.

摘要

目的

我们研究了一种适用于初级保健环境的 12 周基于家庭的认知行为体重管理方案对肥胖儿童的治疗效果。

方法

研究样本由 49 名肥胖儿童(年龄 7-13 岁;平均±标准差:10.68±1.24)组成。这些家庭被随机分配到立即开始治疗或等待 12 周的治疗条件。主要结局评估指标为体重指数标准差评分(BMI SDS)、自尊、抑郁症状和心血管代谢风险的血液参数。评估在基线、治疗结束时、等待治疗结束后和治疗结束 12 个月时进行。

结果

治疗组的平均体重指数标准差评分降低了-0.16 个单位,而等待组则增加了 0.04 个单位(p =.001)。对于整个样本,BMI SDS 在治疗后有显著改善(p =.001),所有自尊指标(p =.001-.041)和抑郁症状(p =.004)都有显著改善。治疗后 BMI SDS 平均降低了-0.18 个单位,在 12 个月随访时仍保持不变。治疗后 12 个月,总胆固醇(p =.03)、LDL-胆固醇(p =.005)和 HDL-胆固醇(p =.01)的血液脂质水平显著降低。大多数心理指标的治疗效果从治疗后到随访时减弱,但并未接近基线水平。男孩的 BMI SDS 降低幅度明显大于女孩(p =.001),而基线精神病合并症对 BMI SDS 结局没有影响。

结论

与等待治疗条件相比,该治疗方案在 BMI SDS、自尊和抑郁症状方面显示出显著而有利的效果。

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