【摘要】 目的:初步探讨认知行为治疗对我国成人注意缺陷多动障碍(ADHD)患者核心症状改善的效果。方法:采用开放性自身对照试验设计,选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)诊断标准的成人ADHD患者58例(18~39岁),进行每周1次、为期12周的认知行为团体治疗。培训方案翻译自Safren的ADHD认知行为治疗手册并根据文化差异做适当修改。使用执行功能行为评定量表成人版自评问卷(BRIEF-A)、自尊量表(SES)分别于基线和第12次治疗结束后进行临床症状评估;用ADHD评定量表于每次治疗结束后对ADHD的核心症状进行评估。结果:12周的治疗过程中ADHD-RS总分逐步减低,在第3周治疗结束后与基线相比差异有统计学意义[(19.0±0.9)vs.(24.8±0.9),P<0.05],到第12周治疗结束后[(15.0±0.8)vs.(24.8±0.9)]差异均有统计学意义(均P<0.01)。第12周治疗结束后,BRIEF-A总分[(133.0±22.7)vs.(155.5±25.4)],行为管理指数[(53.8±9.8)vs.(59.0±11.9)],元认知指数得分[(73.6±15.0)vs.(85.0±16.0)]均低于基线(均P<0.01),SES总分高于基线[(29.7±6.4)vs.(27.1±5.1)],差异有统计学意义(P<0.01)。结论:认知行为团体治疗对成人注意缺陷多动障碍可能有效,值得进一步研究。更多还原

【Abstract】 Objective: To preliminarily investigate the core symptoms improvement of attention-deficit/hyperactivity disorder( ADHD) in adults treated with cognitive behavioral group therapy( CBGT). Methods: With openlabel clinical trial design,58 adult ADHD patients( 18- 39 years) were included. All the patients were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition( DSM-IV). A 12-week CBGT were implemented once a week in all patients. The training plan was translated from Safren’s Handbook of ADHD Cognitive Behavioural Therapy with appropriate modification according to culture difference. Before and after the treatment,the Behavior Rating Inventory of Executive Function-Adult Version Self-Report Form( BRIEF) and the Self-Esteem Scale( SES) were used to evaluate the clinical symptoms, and the ADHD Rating Scale( ADHD-RS) to the core symptoms after each treatment. Results: The ADHD-RS total scores were reduced gradually within 12-week treatment period. The total scores at the 3rd week [( 19. 0 ± 0. 9) vs.( 24. 8 ± 0. 9), P < 0. 05]and the 12th week [( 15. 0 ± 0. 8) vs.( 24. 8 ± 0. 9),P < 0. 01] were both lower than that at the baseline. Compared with the baseline,all the scores of BRIEF-A [( 133. 0 ± 22. 7) vs.( 155. 5 ± 25. 4) ],Behavior Management index[( 53. 8 ± 9. 8) vs.( 59. 0 ± 11. 9) ] and meta-cognitive index scores [( 73. 6 ± 15. 0) vs.( 85. 0 ± 16. 0) ] at the 12th week were significantly reduced( P < 0. 01),while the SES total scores were significantly increased [( 29. 7 ± 6. 4)vs.( 27. 1 ± 5. 1),P < 0. 01]. Conclusion: The cognitive behavioral group therapy might be effective against adult ADHD,which need further investigations.更多还原