Rucklidge Julia J, Blampied F Meredith, Manna Leona, Sherwin Angela, Bagshaw Sue, Mulder Roger T, Boden Joseph
School of Psychology, Speech and Hearing, University of Canterbury, New Zealand.
Psychological Medicine, University of Otago, New Zealand.
Contemp Clin Trials Commun. 2022 Oct 27;30:101027. doi: 10.1016/j.conctc.2022.101027. eCollection 2022 Dec.
Emotional dysregulation (ED) is a significant contributing factor to psychological distress in young people. ED is a transdiagnostic dimension characterized by an excessive reactivity to negative emotional stimuli with affective (anger) and behavioral (aggression) components, and is present across anxiety, mood and behavioral disorders. Due to early onset, high prevalence and persistence, ED in childhood is one of the most psychosocially impairing and cost-intensive mental health conditions, with not enough children improving with conventional treatments. Clinical trials have established preliminary efficacy of micronutrients (vitamins and minerals) in the treatment of ED. This project expands the research to examine micronutrient efficacy for teenagers with ED.
This study is the first double-blind (participant and investigators) 8 week randomized controlled trial (with 8 week open-label extension and one year follow-up) designed to explore the efficacy and safety of micronutrients compared with placebo in 150 medication-free emotionally dysregulated youth (12-17 years), referred via self-referral, delivered remotely throughout New Zealand, using a website for monitoring symptoms, with a psychologist available online via text, email and video for assessment and monitoring. The primary outcome measures will be the Clinical Global Impression (CGI-I), the reactivity subscale of the Emotion Dysregulation Inventory (EDI) and the Clinician Rated Temper and Irritability Scale (CL-ARI).
Micronutrient intervention delivered alongside online assessment and monitoring has the potential to transform delivery of mental health care to young people who may not be willing or able to access traditional therapies. We also hope that this intervention shows acceptability across different ethnicities.
情绪调节障碍(ED)是导致年轻人心理困扰的一个重要因素。ED是一个跨诊断维度,其特征是对带有情感(愤怒)和行为(攻击)成分的负面情绪刺激过度反应,且存在于焦虑、情绪和行为障碍中。由于发病早、患病率高且持续存在,儿童期的ED是社会心理损害最严重且成本高昂的心理健康状况之一,传统治疗方法能改善症状的儿童数量不足。临床试验已证实微量营养素(维生素和矿物质)治疗ED具有初步疗效。本项目扩大研究范围,以检验微量营养素对患有ED的青少年的疗效。
本研究是首个双盲(参与者和研究者双盲)的为期8周的随机对照试验(有8周的开放标签延长期和一年的随访期),旨在探讨与安慰剂相比,微量营养素对150名未服用药物的情绪调节障碍青年(12 - 17岁)的疗效和安全性。这些青年通过自我推荐参与研究,在新西兰各地通过远程方式进行,利用一个网站监测症状,并有一名心理学家通过文本、电子邮件和视频提供在线评估和监测服务。主要结局指标将是临床总体印象量表(CGI - I)、情绪调节障碍量表(EDI)的反应性子量表以及临床医生评定的气质和易怒量表(CL - ARI)。
在在线评估和监测的同时进行微量营养素干预有可能改变为那些可能不愿意或无法接受传统疗法的年轻人提供心理健康护理的方式。我们还希望这种干预在不同种族中都能显示出可接受性。