图雷特障碍儿童的行为治疗:一个随机对照试验
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
概括
一项全面的行为干预措施显著降低了图雷特障碍儿童和青少年的滴滴严重程度. 这种有效的治疗显示了持久的结果,为抗精神病药物提供了一个有希望的替代品.
科学领域:
- 神经学 神经学
- 儿童精神病学 儿童精神病学
- 行为科学 行为科学
背景情况:
- 图雷特障碍是一种儿童发作的慢性神经疾病.
- 抗精神病药物是第一线治疗方法,但有副作用.
- 行为干预需要在大型受控试验中进行评估.
研究的目的:
- 为了确定全面的行为干预措施的有效性,以减少儿童和青少年的滴痛严重程度.
- 在随机试验中,将行为干预与对照治疗进行比较.
主要方法:
- 一个随机的,观察者盲目的,受控的试验,涉及126名儿童 (年龄为9-17) 患有图雷特或慢性滴答障碍.
- 参与者被分配到综合行为干预 (n=61) 或支持性治疗和教育 (n=65) 中.
- 评估包括耶鲁大学的全球严重程度量表和临床全球印象改善量表,随访时间为3个月和6个月.
主要成果:
- 与对照组 (P < .001) 相比,行为干预导致滴滴严重程度的显著降低 (耶鲁全球滴滴严重程度量表).
- 在行为干预组中,更多的儿童表现出显著的改善 (临床全球印象-改善量表;52.5%与18.5%,P <.001).
- 治疗收益是持久的,87%的受访者在6个月后继续享受福利,并且退休率低 (9.5%).
结论:
- 综合性行为干预比支持性治疗和教育更有效,可以改善图雷特症和慢性滴答障碍儿童的症状严重程度.
- 这种干预提供了一个可行的,有效的治疗选择,具有持久的结果.
- 进一步的研究应该探索长期疗效和更广泛的实施.
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