Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, 13001 East 17th Place, MS F570, Aurora, CO 80045, USA.
Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, 13001 East 17th Place, MS F570, Aurora, CO 80045, USA.
Child Adolesc Psychiatr Clin N Am. 2019 Jul;28(3):461-472. doi: 10.1016/j.chc.2019.02.006. Epub 2019 Apr 4.
Substance use disorders (SUDs) are commonly co-occurring among adolescents with depression. Integrated treatment is important given treatment implications and increased rates of suicidality. All adolescents should be screened for SUD using Screening, Brief Intervention, and Referral to Treatment. Review of randomized controlled trials in adolescents reveals motivational enhancement therapy/cognitive behavioral therapy is an evidence-based intervention and should be considered first-line treatment. If depression does not improve, fluoxetine should be considered, as it is well-tolerated in substance-involved adolescents with depression. Adolescents who do not show improvement in SUD or who have severe SUD should be referred to evidence-based SUD treatment.
物质使用障碍（SUD）在患有抑郁症的青少年中经常同时发生。鉴于治疗意义和自杀率的增加，综合治疗很重要。所有青少年都应该使用筛查、简短干预和转介治疗来筛查 SUD。对青少年随机对照试验的回顾显示，动机增强疗法/认知行为疗法是一种循证干预措施，应被视为一线治疗。如果抑郁症没有改善，应该考虑使用氟西汀，因为它在涉及物质的抑郁症青少年中耐受性良好。如果 SUD 没有改善或 SUD 严重的青少年，应转介到基于证据的 SUD 治疗。
