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青少年焦虑症和注意力缺陷多动障碍的治疗反应与感知压力、童年创伤及心理复原力之间的关系:来自土耳其的一项比较研究

The relationship between response to treatment and perceived stress, childhood trauma and psychological resilience in anxiety disorders and attention-deficit hyperactivity disorder in adolescents: A comparative study from Türkiye.

作者信息

Gul Melike Kevser, Cagir Busra, Demirci Esra, Ozmen Sevgi

机构信息

Department of Child and Adolescent Psychiatry, Erciyes University School of Medicine, Kayseri, Türkiye.

Department of Child and Adolescent Psychiatry, Erciyes University School of Medicine, Kayseri, Türkiye.

出版信息

Arch Psychiatr Nurs. 2025 Apr;55:151856. doi: 10.1016/j.apnu.2025.151856. Epub 2025 Mar 9.

Abstract

OBJECTIVE

In recent years, personalized treatments and factors affecting treatment response have gained importance in psychiatry. This study aimed to evaluate the effect of perceived stress, childhood trauma, and resilience levels on response to treatment in anxiety disorders (AD) and attention-deficit hyperactivity disorder (ADHD) in adolescents.

METHOD

A total of 202 adolescents were included in this study. The treatment response of patients with AD and ADHD who were diagnosed according to DSM-5 criteria and used pharmacological treatment was determined by using the Clinical Global Impression- Improvement scale in their control examinations. Forty patients with AD who responded to treatment (AD/Responder), 35 patients who did not respond (AD/Non-responder), 55 treatment responder patients with ADHD (ADHD/Responder), and 21 non-responder patients (ADHD/Non-responder), and 51 healthy controls (HC) were included in the study. They completed the Perceived Stress Scale (PSS), Childhood and Youth Resilience Measure-12 (CYRM-12), and Childhood Trauma Questionnaire (CTQ).

RESULTS

The PSS score was found to be significantly lower in the ADHD/Responder group compared to AD/Responder and ADHD/Non-responder groups. The PSS score was lower, and CYRM-12 score was significantly higher in the ADHD/Responder and HC groups compared to the AD/Non-responder group. Emotional abuse scores, a subscale of CTQ, were considerably higher in the AD/Non-responder group compared to AD/Responder and ADHD/Responder. There were significant positive correlations between PSS and CTQ and its subscale scores; negative correlations were found between CYRM-12 and CTQ scores and CYRM-12 and PSS scores in groups.

CONCLUSIONS

There were considerable relationships between treatment response and resilience, perceived stress and emotional abuse in adolescents with AD and ADHD. In addition to drug treatments, resilience and stress-based interventions can be used to increase treatment response especially in AD.

摘要

目的

近年来,个性化治疗以及影响治疗反应的因素在精神病学领域愈发重要。本研究旨在评估感知压力、童年创伤和复原力水平对青少年焦虑症(AD)和注意力缺陷多动障碍(ADHD)治疗反应的影响。

方法

本研究共纳入202名青少年。根据《精神疾病诊断与统计手册》第五版(DSM - 5)标准诊断并接受药物治疗的AD和ADHD患者,在对照检查中使用临床总体印象改善量表来确定其治疗反应。研究纳入了40名对治疗有反应的AD患者(AD/反应者)、35名无反应的患者(AD/无反应者)、55名对治疗有反应的ADHD患者(ADHD/反应者)、21名无反应患者(ADHD/无反应者)以及51名健康对照者(HC)。他们完成了感知压力量表(PSS)、儿童与青少年复原力量表 - 12(CYRM - 12)和儿童创伤问卷(CTQ)。

结果

发现ADHD/反应者组的PSS得分显著低于AD/反应者组和ADHD/无反应者组。与AD/无反应者组相比,ADHD/反应者组和HC组的PSS得分更低,而CYRM - 12得分显著更高。CTQ的一个子量表情绪虐待得分,AD/无反应者组显著高于AD/反应者组和ADHD/反应者组。PSS与CTQ及其子量表得分之间存在显著正相关;各小组中CYRM - 12与CTQ得分以及CYRM - 12与PSS得分之间存在负相关。

结论

在患有AD和ADHD的青少年中,治疗反应与复原力、感知压力和情感虐待之间存在显著关系。除药物治疗外,基于复原力和压力的干预措施可用于提高治疗反应,尤其是在AD治疗中。

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