Kaminer Y, Burleson J A, Blitz C, Sussman J, Rounsaville B J
Alcohol Research Center, Department of Psychiatry, University of Connecticut, School of Medicine, Farmington 06030-1410, USA.
J Nerv Ment Dis. 1998 Nov;186(11):684-90. doi: 10.1097/00005053-199811000-00004.
This study tested the hypothesis that dually diagnosed adolescent substance abusers could be matched to effective treatments on the basis of their comorbid psychopathology. Specifically, patients with externalizing disorders would have better outcomes when treated with cognitive-behavioral group treatment (CBT), and subjects with internalizing disorders without comorbid externalizing disorders would fare better in interactional group treatment (IT). Thirty-two dually diagnosed adolescent substance abusers were randomized into two 12-week manual guided outpatient group psychotherapies: CBT and IT. At 3-month follow-up, no patient-treatment matching effects were identified. Adolescents assigned to CBT demonstrated a significant reduction in severity of substance use compared with those assigned to IT. Improvement in severity of family function showed a trend in favor of CBT. School function, peer-social relationships, legal problems, and psychiatric severity all showed a consistent nonsignificant direction in favor of CBT over IT. CBT appears to be a promising short-term psychosocial intervention for adolescents.
本研究检验了这样一个假设，即双重诊断的青少年药物滥用者可以根据其共病的精神病理学特征匹配有效的治疗方法。具体而言，患有外化障碍的患者在接受认知行为团体治疗（CBT）时会有更好的治疗效果，而患有内化障碍且无共病外化障碍的受试者在互动团体治疗（IT）中表现会更好。32名双重诊断的青少年药物滥用者被随机分为两种为期12周的手册指导门诊团体心理治疗：CBT和IT。在3个月的随访中，未发现患者与治疗的匹配效应。与分配到IT组的青少年相比，分配到CBT组的青少年药物使用严重程度显著降低。家庭功能严重程度的改善显示出有利于CBT的趋势。学校功能、同伴社交关系、法律问题和精神疾病严重程度在所有方面均显示出一致的、有利于CBT而非IT的不显著倾向。CBT似乎是一种对青少年有前景的短期社会心理干预方法。
