Healthy Childhood Brain Development and Developmental Traumatology Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 104360, Durham, NC 27710, USA.
Department of Psychology, University of North Carolina Wilmington, 601 South College Road, TL 2074, Wilmington, NC 28409, USA.
Child Adolesc Psychiatr Clin N Am. 2019 Jul;28(3):289-302. doi: 10.1016/j.chc.2019.02.002. Epub 2019 Apr 4.
Maltreatment affects 9.1 to 17.1 of every 1000 US children and adolescents. Maltreated youth are at high risk for depression. Clinicians should screen young patients for maltreatment history. Depressed maltreated youth are at high risk for treatment resistance. Combination treatment with selective serotonin reuptake inhibitors and cognitive behavior therapy (CBT) with a trauma-informed approach should be considered for depressed maltreated youth. Behavioral management can be integrated with trauma-focused CBT to treat the externalizing disorders that commonly occur in maltreated depressed youth. If one approach is unsuccessful, a change to another medication or type of evidence-based psychotherapy or intervention is indicated.
虐待影响每 1000 名美国儿童和青少年中的 9.1 至 17.1 人。受虐待的年轻人患抑郁症的风险很高。临床医生应筛查年轻患者的虐待史。受虐待后抑郁的年轻人对治疗有很强的抵抗力。对于受虐待后抑郁的年轻人，应考虑使用选择性 5-羟色胺再摄取抑制剂联合认知行为治疗（CBT），且采用以创伤为中心的方法。行为管理可以与以创伤为中心的 CBT 相结合，以治疗常见于受虐待的抑郁青少年的外化障碍。如果一种方法不成功，则表明需要更换另一种药物或类型的基于证据的心理治疗或干预措施。
