Augmenting Cognitive Behavior Therapy for School Refusal with Fluoxetine: A Randomized Controlled Trial
Augmenting Cognitive Behavior Therapy for School Refusal with Fluoxetine: A Randomized Controlled Trial
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DOI：
10.1007/s10578-016-0675-y
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发表时间：
2017-06-01
影响因子：
2.9
通讯作者：
Tonge, Bruce J.
中科院分区：
文献类型：
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作者：
Melvin, Glenn A.;Dudley, Amanda L.;Tonge, Bruce J.
本研究调查了氟西汀强化认知行为疗法 (CBT) 是否可以改善焦虑拒绝上学的青少年（11-16.5 岁）的治疗结果。 62 名参与者被随机分配至单独 CBT、CBT + 氟西汀或 CBT + 安慰剂组。所有治疗均耐受良好； CBT + 安慰剂组有 1 次自杀未遂。所有小组在主要（入学率）和次要结果指标（焦虑、抑郁、自我效能和临床医生评价的整体功能）方面都有显着改善；涨幅基本维持在6个月和1年期。很少有参与者在急性治疗后摆脱焦虑症。在随访期间，焦虑症和抑郁症继续下降，而入学率保持稳定，约为 54%。唯一显着的组间差异是 CBT + 氟西汀组的青少年报告的治疗满意度高于单独 CBT 组。这些结果表明拒绝上学的现象长期存在，以及未来需要研究如何最好地提高入学率。
This study investigates whether the augmentation of cognitive behavior therapy (CBT) with fluoxetine improves outcomes in anxious school refusing adolescents (11-16.5 years). Sixty-two participants were randomly allocated to CBT alone, CBT + fluoxetine or CBT + placebo. All treatments were well tolerated; with one suicide-attempt in the CBT + placebo group. All groups improved significantly on primary (school attendance) and secondary outcome measures (anxiety, depression, self-efficacy and clinician-rated global functioning); with gains largely maintained at 6-months and 1-year. Few participants were anxiety disorder free after acute treatment. During the follow-up period anxiety and depressive disorders continued to decline whilst school attendance remained stable, at around 54 %. The only significant between-group difference was greater adolescent-reported treatment satisfaction in the CBT + fluoxetine group than the CBT alone group. These results indicate the chronicity of school refusal, and the need for future research into how to best improve school attendance rates.