Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
Department of Psychiatry and University of Texas Southwestern, Dallas, Texas, USA.
J Child Adolesc Psychopharmacol. 2021 Dec;31(10):685-691. doi: 10.1089/cap.2021.0043. Epub 2021 Jul 28.
Parent-child interaction therapy (PCIT) is an evidence-based approach for children aged 2-7 years with disruptive behavior problems. This study examined the effectiveness of PCIT with and without concurrent pharmacotherapy. A convenience sample was collected from a retrospective chart review of preschool-aged children treated with PCIT at the Mayo Clinic Young Child Clinic between 2016 and 2020. Quantitative and qualitative data were abstracted from all patients. The sample was divided into two groups based on psychotropic medications status (medicated and unmedicated) at the initiation of PCIT. Effectiveness of treatment was assessed with the change in Eyberg Child Behavior Inventory (ECBI) score. The change over time in ECBI score was compared between the two PCIT groups with and without concurrent pharmacotherapy using a linear mixed model. Of the 62 youth, 38.71% were females. Mean age was 4.71 ± 1.17 years. The mean baseline ECBI score was 148.74 ± 30.86, indicating clinically significant disruptive behaviors. The mean number of PCIT sessions was 6.59 ± 3.82. There was no statistically significant difference in ECBI scores between the two groups at pre-PCIT (medication group: 149.68, standard error [SE] = 11.61 vs. unmedicated group: 147.92, SE = 10.93, = 0.8904) and at post-PCIT (medication group: 116.27 [SE = 11.89] vs. unmedicated group: 128.86 [SE = 11.57], = 0.3464). There was a statistically significant improvement in ECBI scores for both groups after completing therapy (medication group = -33.41 [-22.32%], SE = 6.27, < 0.0001; = 1.144; unmedicated group = -19.06 [-12.88%], SE = 5.78, = 0.0022; = 1.078). PCIT reduced disruptive behaviors in this sample of young children regardless of concurrent pharmacotherapy. Future prospective studies should consider one particular pharmacological agent and long-term outcomes of treatment. PCIT and certain pharmacological treatments could have complex and important bidirectional priming effects for both treatments.
父母-儿童互动治疗（PCIT）是一种针对 2-7 岁有破坏性行为问题的儿童的循证方法。本研究考察了 PCIT 联合和不联合共病药物治疗的效果。从 2016 年至 2020 年期间在梅奥诊所幼儿诊所接受 PCIT 治疗的学龄前儿童的回顾性图表审查中收集了便利样本。从所有患者中提取了定量和定性数据。根据 PCIT 开始时的精神药物状态（用药和未用药）将样本分为两组。用 Eyberg 儿童行为清单（ECBI）评分的变化来评估治疗的效果。使用线性混合模型比较了共病药物治疗组和无共病药物治疗组的 ECBI 评分随时间的变化。在 62 名青少年中，38.71%为女性。平均年龄为 4.71±1.17 岁。基线 ECBI 评分平均为 148.74±30.86，表明存在明显的破坏性行为。PCIT 疗程的平均次数为 6.59±3.82。在 PCIT 前（用药组：149.68，标准误差 [SE] = 11.61 与未用药组：147.92，SE = 10.93， = 0.8904）和 PCIT 后（用药组：116.27 [SE = 11.89] 与未用药组：128.86 [SE = 11.57]， = 0.3464），两组之间的 ECBI 评分没有统计学上的显著差异。两组在完成治疗后，ECBI 评分均有统计学显著改善（用药组-33.41[-22.32%]，SE=6.27， < 0.0001； = 1.144；未用药组-19.06[-12.88%]，SE=5.78， = 0.0022； = 1.078）。PCIT 降低了该年轻儿童样本中的破坏性行为，无论是否同时进行药物治疗。未来的前瞻性研究应考虑一种特定的药物，并考虑治疗的长期结果。PCIT 和某些药物治疗可能对两种治疗都有复杂而重要的双向启动作用。
