Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden.
BMC Psychiatry. 2018 Nov 26;18(1):371. doi: 10.1186/s12888-018-1947-9.
To investigate the outcome of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) in terms of reducing suffering and increasing functional adjustment among self-harming and/or suicidal adolescents with high symptom loads and their families.
Forty-nine self-harming and/or suicidal adolescents, M = 14.6, of predominantly Swedish origin and female gender (85.7%) participated with their parents. The study had a within group design with repeated measures at pre- and post-treatment, as well as six- and twelve-months follow-ups. Self-reports were used for the main outcomes; self-harm rates, suicide attempts, parent-reported days of inpatient/institutional care, internalized and externalized symptoms, perceived stress, emotion regulation, school hours and adjustment. Secondary outcomes were levels of reported expressed emotions within family dyads, as well as parental anxiety, depression and stress.
From pre- to post-assessment, the adolescents reported significant reductions of self-harm (p = .001, d = 0.54) and suicide attempts (p < .0001, d = 1.38). Parent-reported days of inpatient/institutional care were reduced, as well as parent- and adolescent-reported internalizing and externalizing symptoms. Furthermore, school attendance and adjustment were improved, and the adolescents reported experiencing less criticism while parents reported less emotional over-involvement. The results were maintained at follow-ups.
The adolescents and the parents reported improvements for the main outcomes. This treatment appears promising in keeping the families in treatment and out of hospital, suggesting that an integrative approach may be beneficial and feasible for this group.
This study has been approved 19/12 2011, by the regional review board in Stockholm (Dnr 2011/1593-31/5).
本研究旨在探讨个体和家庭综合治疗（强化心理社会治疗：ICT）对有高症状负荷的自伤和/或自杀青少年及其家庭减轻痛苦和提高功能调整的效果。
49 名有自伤和/或自杀行为的青少年（M=14.6，主要为瑞典裔，女性占 85.7%）及其父母参与了研究。该研究采用了组内设计，在治疗前、治疗后、6 个月和 12 个月随访时进行了重复测量。主要结果采用自我报告的方式评估，包括自伤率、自杀企图、父母报告的住院/机构护理天数、内化和外化症状、感知压力、情绪调节、上学时间和适应情况。次要结果为家庭双元体中报告的表达情绪水平，以及父母的焦虑、抑郁和压力。
从治疗前到治疗后，青少年报告的自伤（p=0.001，d=0.54）和自杀企图（p<0.0001，d=1.38）显著减少。父母报告的住院/机构护理天数减少，青少年和父母报告的内化和外化症状也减少。此外，上学出勤率和适应情况得到改善，青少年报告的批评减少，而父母报告的情感过度卷入减少。随访结果也保持稳定。
青少年和家长报告的主要结果都有所改善。这种治疗方法似乎可以让家庭保持在治疗中，避免住院，这表明综合治疗方法可能对这一群体有益且可行。
本研究于 2011 年 12 月 19 日经斯德哥尔摩地区伦理审查委员会批准（编号：2011/1593-31/5）。
