The identification and psychological treatment of panic disorder in adolescents: a survey of CAMHS clinicians
The identification and psychological treatment of panic disorder in adolescents: a survey of CAMHS clinicians
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DOI：
10.1111/camh.12372
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发表时间：
2020-02-23
影响因子：
6.1
通讯作者：
Waite, Polly
中科院分区：
文献类型：
--
作者：
Baker, Holly J.;Waite, Polly
背景 大约 1% 的青少年患有恐慌症，对社会和学业功能有重大影响。初步证据支持惊恐障碍特异性治疗对患有惊恐障碍的青少年的有效性；然而，由于与其他焦虑症的症状重叠以及对其他人来说更明显的其他困难，惊恐障碍在青少年中可能会被忽视。本研究的目的是确定国家医疗服务体系 (NHS) 儿童和青少年心理健康服务 (CAMHS) 临床医生在心理治疗和恐慌症方面接受过哪些培训，以及他们如何识别和治疗青少年恐慌症。 方法 参与为患有焦虑症的儿童和青少年提供心理治疗的来自不同专业的 CAMHS 临床医生 (n = 427)。他们完成了一项横断面在线调查，其中包括描述一名患有恐慌症的青少年的小插图，并被要求确定主要的诊断或出现的问题。 结果 不到一半的临床医生 (48.6%) 认为恐慌症或恐慌症状是小插图中的主要出现问题。大多数临床医生建议 CBT 将是他们的治疗方法。然而，很少有人确定针对患有恐慌症的年轻人的循证治疗方案。几乎一半的样本没有接受过认知行为治疗 (CBT) 培训，大约五分之一的人没有接受过提供心理治疗的培训。 结论 只有一半的 CAMHS 临床医生从小插曲中识别出恐慌症，尽管广泛提供 CBT 治疗，但只有少数患有恐慌症的青少年正在接受专为患有恐慌症的年轻人开发和评估的治疗方法。迫切需要对临床医生进行培训、使用有助于识别的工具以及在 CAMHS 内实施循证治疗。
Background Panic disorder is experienced by around 1% of adolescents and has a significant impact on social and academic functioning. Preliminary evidence supports the effectiveness of panic disorder-specific treatment in adolescents with panic disorder; however, panic disorder may be overlooked in adolescents due to overlapping symptoms with other anxiety disorders and other difficulties being more noticeable to others. The aim of this study was to establish what training National Health Service (NHS) Child and Adolescent Mental Health Services (CAMHS) clinicians have received in psychological therapies and panic disorder and how they identify and treat panic disorder in adolescents.Method CAMHS clinicians from a range of professions (n = 427), who were delivering psychological treatments to children and adolescents with anxiety disorders, participated. They completed a cross-sectional, online survey, including a vignette describing an adolescent with panic disorder, and were asked to identify the main diagnosis or presenting problem.Results Less than half the clinicians (48.6%) identified panic disorder or panic symptoms as the main presenting problem from the vignette. The majority of clinicians suggested CBT would be their treatment approach. However, few identified an evidence-based treatment protocol for working with young people with panic disorder. Almost half the sample had received no training in cognitive behaviour therapy (CBT), and around a fifth had received no training in delivering psychological treatments.Conclusions Only half of CAMHS clinicians identified panic disorder from a vignette and although CBT treatments are widely offered, only a minority of adolescents with panic disorder are receiving treatments developed for and evaluated with young people with panic disorder. There is a vital need for clinician training, the use of tools that aid identification and the implementation of evidence-based treatments within CAMHS.