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一项针对有药物滥用问题青少年的家庭导向治疗项目:与复发及学业或社会状况相关的长期结果

A family-oriented therapy program for youths with substance abuse: long-term outcomes related to relapse and academic or social status.

作者信息

Wang Liang-Jen, Lu Shing-Fang, Chong Mian-Yoon, Chou Wen-Jiun, Hsieh Yu-Lian, Tsai Tung-Ning, Chen Ching, Lee Yi-Hsuan

机构信息

Department of Child and Adolescent Psychiatry, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

Neuropsychiatr Dis Treat. 2016 Mar 30;12:699-706. doi: 10.2147/NDT.S105199. eCollection 2016.

Abstract

OBJECTIVE

The abuse of illegal substances by youths in Taiwan has become a major public health issue. This study explores the outcomes (relapse rate and academic or social status) of a family-oriented therapy program conducted for substance-using youths who were referred by a judge to participate in it.

METHODS

The present study includes 121 participants categorized into three groups: 36 youths underwent a weekly ten-session outpatient motivational enhancement psychotherapy (MEP) group program; 41 youths participated in a program that combined the aforementioned MEP program with an additional weekly ten-session parenting skill training (PST) program for their guardians (MEP + PST group); and 44 adolescents who received standard supervision by the court served as the control group. All participants were followed-up for a maximum of 2 years.

RESULTS

Of the 121 participants (mean age: 16.1±1.1 years), 33.1% relapsed into substance use during the follow-up period. The probability of relapse did not differ significantly between the MEP group (36.1%) and the control group (40.9%), but the youths in the MEP + PST group (22.0%) were at a lower risk of relapse than the control group participants (adjusted hazard ratio =0.48, 95% confidence interval [CI] =0.21-1.09). By the end of the study follow-up period, participants in both the MEP group and the MEP + PST group were more likely to be attending school (MEP group: adjusted odds ratio [aOR] =6.61, 95% CI =1.60-27.35; MEP + PST group: aOR =8.57, 95% CI =1.94-37.82) or employed (MEP group: aOR =7.75, 95% CI =1.95-30.75; MEP + PST group: aOR =7.27, 95% CI =1.76-29.97), when compared to the control group.

CONCLUSION

This study revealed that a family-oriented treatment approach may be a more effective option for preventing youths' relapsing into substance abuse. In comparison to individuals who received standard supervision by the court, those who received MEP experienced a better school attendance or social outcome over the follow-up period.

摘要

目的

台湾青少年滥用非法药物已成为一个重大的公共卫生问题。本研究探讨了针对被法官转介参与的药物使用青少年开展的家庭导向治疗项目的结果(复发率以及学业或社会状况)。

方法

本研究纳入121名参与者,分为三组:36名青少年参加了为期十周、每周一次的门诊动机增强心理治疗(MEP)小组项目;41名青少年参加了一个项目,该项目将上述MEP项目与为其监护人额外开展的为期十周、每周一次的育儿技能培训(PST)项目相结合(MEP + PST组);44名接受法庭标准监管的青少年作为对照组。所有参与者最长随访2年。

结果

在121名参与者(平均年龄:16.1±1.1岁)中,33.1%在随访期间复发药物使用。MEP组(36.1%)和对照组(40.9%)的复发概率无显著差异,但MEP + PST组的青少年(22.0%)复发风险低于对照组参与者(调整后风险比 =0.48,95%置信区间[CI]=0.21 - 1.09)。到研究随访期结束时,与对照组相比,MEP组和MEP + PST组的参与者更有可能上学(MEP组:调整后优势比[aOR]=6.61,95%CI =1.60 - 27.35;MEP + PST组:aOR =8.57,95%CI =1.94 - 37.82)或就业(MEP组:aOR =7.75,95%CI =1.95 - 30.75;MEP + PST组:aOR =7.27,95%CI =1.76 - 29.97)。

结论

本研究表明,家庭导向的治疗方法可能是预防青少年复吸药物滥用的更有效选择。与接受法庭标准监管的个体相比,接受MEP治疗的个体在随访期间的上学出勤率或社会结局更好。

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