チューレット症候群の子供の行動療法:ランダム化制御試験
John Piacentini1, Douglas W Woods, Lawrence Scahill
1UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room 68-251, Los Angeles, CA 90024, USA. jpiacentini@mednet.ucla.edu
JAMA
|May 21, 2010
まとめ
総合的な行動介入により,トゥレット症候群の子どもおよび青少年におけるチックの重症度が著しく低下しました. この効果的な治療法は,耐久的な結果を示し,抗精神病薬の有望な代替品を提供しました.
科学分野:
- 神経学 神経学とは
- 児童精神科は,児童精神科に属している.
- 行動科学は,行動科学である.
背景:
- ツーレット症候群は,幼児期に発症する慢性神経疾患である.
- 抗精神病薬はファーストラインの治療法ですが,副作用があります.
- 行動介入は,大規模統制試験での評価を必要とします.
研究 の 目的:
- ティックの重症度を下げるための包括的な行動介入の有効性を決定する. 子供と青少年におけるティックの重症度を下げるための包括的な行動介入の有効性を決定する.
- ランダム化試験における対照治療と行動介入を比較する.
主な方法:
- ツーレット症候群または慢性チック症候群の126人の子ども (年齢9〜17歳) を対象としたランダム化,観察者盲検,制御試験.
- 参加者は,包括的な行動介入 (n=61) またはサポート療法と教育 (n=65) に割り当てられました.
- 評価には,イエール・グローバル・ティス・セリバーティ・スケールとクリニカル・グローバル・インプレッション・イムプリーメント・スケールが含まれ,フォローアップは3ヶ月と6ヶ月で行われました.
主要な成果:
- 行動介入は,対照群 (P < .001) に比べて,チックの重度 (イエール・グローバル・チックの重度スケール) が著しく減少した.
- 行動介入グループでは,より多くの子どもたちが有意な改善を示した (クリニック・グローバル・インプレッション・インプレッション・スケール; 52.5%対18.5%,P <.001).
- 治療による利益は持続的であり,回答者の87%が6ヶ月後に利益を維持し,減退率は低い (9.5%).
結論:
- 総合的な行動介入は,トゥレット症候群と慢性チック障害の子供の症状の重度を改善するために,サポート療法と教育よりも効果的です.
- この介入は,持続的な結果をもたらす,実行可能で効果的な治療の選択肢を提供します.
- 長期的な有効性やより広範な実施について,さらなる研究が進められることが望ましい.
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