Efficacy of Outpatient Aftercare for Adolescents With Alcohol Use Disorders: A Randomized Controlled Study
Efficacy of Outpatient Aftercare for Adolescents With Alcohol Use Disorders: A Randomized Controlled Study
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DOI：
10.1097/chi.0b013e318189147c
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发表时间：
2008-12-01
影响因子：
13.3
通讯作者：
Burke, Rebecca H.
中科院分区：
文献类型：
--
作者：
Kaminer, Yifrah;Burleson, Joseph A.;Burke, Rebecca H.
目的：接受治疗的患有酒精使用障碍 (AUD) 的青少年在治疗完成后 3 至 6 个月内的复发率约为 60%。这项随机对照研究测试了以下假设：积极的术后护理可能比没有积极的术后护理 (NA) 更好地维持治疗效果。方法：共有 177 名 13 至 18 岁被诊断患有 DSM-IV AUD 的青少年参加了每周九次的门诊认知行为治疗小组课程。 144 名治疗完成者被随机分为 5 次面对面治疗、简短电话治疗或 NA 治疗组。三个饮酒变量是 130 名善后护理完成者的主要结果指标。结果：在护理结束时，与治疗结束时相比，复发的可能性显着增加。然而，在北美地区，处于积极善后护理 (AA) 条件下的青少年复发的可能性显着增加 (p = 0.008)。这种效应主要是由显着的性别 x 积极的术后护理相互作用驱动的：女孩在 AA 下没有表现出明显的复发，但在 NA 中则显着复发。与 NA 相比，参加 AA 的青少年每月饮酒天数 (p = .044) 和重度饮酒天数 (p = .035) 也显着减少。结论：总体而言，积极的术后护理干预措施在减缓预期的治疗后酗酒复发过程方面显示出一定的功效，并且仅对女孩维持治疗效果。应进一步检查干预频率、剂量反应、善后阶段的持续时间和行为改变的中介因素，以优化 AUD 青少年的善后护理。 J. Am.阿卡德。儿童青少年。精神病学，2008；47(12)：1405-1412。
Objective: Relapse rates for treated adolescents with alcohol use disorders (AUDs) amount to approximately 60% at 3 to 6 months after treatment completion. This randomized controlled study tested the hypothesis that active aftercare may maintain treatment gains better than no active aftercare (NA). Method: A total of 177 adolescents, 13 to 18 years of age, diagnosed with DSM-IV AUD, participated in nine weekly outpatient cognitive behavioral therapy group sessions. The 144 treatment completers were randomized into a 5-session in-person, brief telephone, or NA condition. Three alcohol use variables were the main outcome measures for 130 aftercare completers. Results: At the end of aftercare, the likelihood of relapse increased significantly compared with end of treatment outcomes. The likelihood of relapse for youths in NA, however, increased significantly more for youths in combined active aftercare (AA) conditions (p =.008). This effect was driven primarily by a significant sex x active aftercare interaction: girls showed no significant relapse under AA but relapsed significantly in NA. Youths enrolled in AA also showed significantly fewer drinking days (p =.044) and fewer heavy drinking days (p =.035) per month relative to NA. Conclusions: In general, active aftercare interventions showed certain efficacy in slowing the expected posttreatment relapse process for alcohol use, with maintenance of treatment gains only for girls. Frequency of interventions, dose-response, duration of aftercare phase, and mediators of behavior change should be examined further to optimize aftercare for youths with AUD. J. Am. Acad. Child Adolesc. Psychiatry, 2008;47(12):1405-1412.