认知行为治疗拒绝上学的研究

目的：探讨认知行为治疗（CBT）及联合氟西汀治疗拒绝上学的疗效。方法：选择2009年10月至2012年10月符合拒绝上学诊断标准的患者95例,年龄8～18岁。将95例患者随机分为CBT组（n=47）、CBT＋氟西汀组（n=48）,疗程12周,治疗前后采用焦虑自评量表（SAS）、抑郁自评量表（SDS）评价,记录每组的返校率。结果：CBT组治疗前后SAS和SDS比较差异有统计学意义（P〈0.01）,返校率74.5%；CBT＋氟西汀组治疗前后SAS和SDS评分比较差异有统计学意义（P〈0.01）,返校率83.3%。两组间返校率比较差异无统计学意义（P〉0.05）。结论：CBT和CBT联合氟西汀均可以有效治疗拒绝上学,氟西汀不能提高CBT治疗拒绝上学的疗效。

A Research on the Cognitive Behaviour Therapy for School Refusal

Objective： To study and evaluate the effects of the cognitive behaviour therapy（CBT） and the CBT plus fluoxetine treatment for school refusal（ SR）. Methods： Ninty-five patients who met the criteria of SR were randomized into two groups： the CBT group（ n = 47）,and CBT plus fluoxetine group（ n = 48）. The treatment lasted 12 weeks. The Self-Rating Anxiety Scale（ SAS）,the Self-Rating Depression Scale（ SDS） were conducted before and after treatment. Results： After 12 weeks,in the CBT group,the SAS scores and SDS scores were significantly decreased（ P 〈 0. 01）,and the percentage of school attendance was 74. 5%; In the CBT plus fluoxetine group,the SAS scores and SDS scores were significantly decreased（ P 〈 0. 01）,and the percentage of school attendance was 83. 3%. There was no significantly difference in the percentage of school attendance between two groups（ P 〉 0. 05）.Conclusions： The CBT and CBT plus fluoxetine can both effectively treat SR,and the fluoxetine is not able to increase the efficacy of treatment for SR.