对患有焦虑症的青少年进行分级照顾与分层照顾:试验性随机对照试验
Elin Olsson1,2, Per Andrén3,4, Emma Claesdotter-Knutsson3,4
1Department of Child and Adolescent Psychiatry, Skåne University Hospital, Lund, Sweden. elin.olsson@med.lu.se.
Child psychiatry and human development
|August 21, 2025
概括
这项试点研究发现,对青少年焦虑症的分阶段和分层照顾模式进行比较是可行的. 分层治疗显示出更高的初始响应率,这表明未来的最终试验的可能性.
科学领域:
- 儿童和青少年精神病学
- 心理健康服务研究
- 临床试验设计
背景情况:
- 焦虑症在年轻人中很常见, 然而获得基于证据的治疗仍然是一个挑战.
- 目前的指导方针通常建议分层护理,但正在探索阶段性护理模式的潜在成本效益.
- 对儿童焦虑症的比较护理模式的研究有限.
研究的目的:
- 评估试点随机对照试验 (RCT) 的可行性,可接受性和安全性.
- 为了比较分阶段照顾与分层照顾治疗焦虑症的青少年.
- 为研究这些护理模式的最终试验设计提供信息.
主要方法:
- 一个试点RCT (NCT06016907) 招募了51名患有焦虑症的年轻人 (平均年龄为14.18岁).
- 阶段性护理是通过互联网提供CBT开始的;对于复杂的病例,分层护理是通过亲临CBT开始的.
- 这两组都接受了非响应者的亲身CBT; 遵守和安全性被监测.
主要成果:
- 在各个干预措施中观察到高坚持 (78-84%) 和出席率 (96%).
- 没有报告严重的不良反应,表明安全性.
- 阶段性治疗的初始反应率为40%,分层治疗的初始反应率为75%.
结论:
- 对于青少年焦虑障碍的逐步和分层治疗, 一个明确的试验是可行的.
- 试点研究显示了可接受的依从性,安全性和初步反应差异.
- 需要进一步的研究来确定儿童焦虑症的疗效和最佳治疗途径.
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