杨宏亮 王美娟 冯志强 张昌

【摘要】 目的：探讨认知行为疗法结合舍曲林治疗青少年抑郁症的临床效果。方法：选取2016年5月-2017年5月本院收治的青少年抑郁症患者92例作为研究对象，按照随机数字表法将其分为联合治疗组和单纯药物组，各46例。联合治疗组在接受药物治疗的同时给予认知行为治疗，单纯药物组单纯给予盐酸舍曲林药物治疗，观察比较两组治疗前与治疗第4、8、12周的效果及不良反应发生情况。结果：治疗第4、8、12周的HAMD评分较治疗前均明显下降且随着治疗时间的增长评分逐渐降低，联合治疗组均明显低于单纯药物组，差异均有统计学意义（P<0.05）。治疗第8、12周的SCL-90评分较治疗前及治疗第4周均明显下降且随着治疗时间的增长评分逐渐降低，联合治疗组均明显低于单纯药物组，差异均有统计学意义（P<0.05）。联合治疗组不良反应的发生率明显低于单纯用药组，差异有统计意义（P<0.05）。结论：认知行为疗法结合舍曲林治疗青少年抑郁症有较好的效果，值得临床推广使用。

【关键词】 认知行为疗法； 青少年； 抑郁症； 舍曲林

【Abstract】 Objective：To explore the clinical effect of cognitive behavioral therapy combined with Fluoxetine in the treatment of adolescent depression.Method：A total of 92 adolescent patients with depression admitted in our hospital from May 2016 to May 2017 were selected as the study objects.According to the random number table method， they were divided into combined treatment group and single drug group， 46 cases in each group.The combined treatment group was treated with cognitive behavioral therapy while received drug treatment，the single drug group was treated with Fluoxetine hydrochloride alone.The therapeutic effects and adverse reactions before and after treatment 4，8 and 12 weeks between the two groups were observed and compared.Result： The HAMD scores of after treatment 4，8 and 12 weeks were significantly lower than those before treatment and gradually decreased with the increase of treatment time；the combined treatment group were significantly lower than those in the single drug group，the differences were statistically significant （P<0.05）.After treatment 8 and 12 weeks，the SCL-90 scores were significantly lower than those before and after treatment 4 weeks，and gradually decreased with the increase of treatment time；the combined treatment group were significantly lower than those of the simple drug group，the differences were statistically significant （P<0.05）.The incidence of adverse reactions in the combined treatment group was significantly lower than that in the simple medication group，the difference was statistically significant （P<0.05）.

Conclusion：Cognitive behavioral therapy combined with Fluoxetine has a good effect in the treatment of adolescent depression，which is worthy of clinical application.

【Key words】 Cognitive behavioral therapy； Adolescent； Depression； Fluoxetine

First-authors address：Shenyang Mental Health Center，Shenyang 110168，China

doi：10.3969/j.issn.1674-4985.2018.32.035

目前抑郁癥作为一种常见的精神类疾病，发病率呈现出逐年升高的趋势，近年来青少年抑郁症占抑郁症患者的比例不断加重且发病率随着年龄增长而不断增加[1]。由于青少年的心理发育缺乏稳定性，常会面临如环境适应能力差、学习压力过大或者人际关系处理不佳等情形，当解决处理此方面问题能力不足时便易产生抑郁症状[2]。据以往研究报道显示，青少年产生抑郁症状的主要病因有遗传因素、社会因素、家庭因素、生活应激事件等[3]。其抑郁的主要表现为易有冲动行为、情绪波动大。有文献研究表明，当青少年患有明显的抑郁症状时，同时进行心理干预以及服用抗抑郁药物十分必要[4]。舍曲林药物既往常被用于青少年抑郁症方面的研究……