| Objectives :(1) To know the psychological state and its influential factors of TD child patients and their parents, so as to provide basis for psychological intervention among TD child patients.(2) To study the treatment of systematize group behavior intervention on TD child patients, in order to provide clinical guideline of behavior therapy on TD child patients.Methods: Prospective case-control method was used. 132 chronic CTD or TS child patients were chosen as research objects from child neurology clinic in our hospital, which were randomly divided into three groups as behavior intervention group(n=47), medicine treatment group(n=47) and combined intervention group(n=38).(1) Intervention methods: “CHEN four stages” group-behavior intervention was designed based on psychological behavior treatment principle. Behavior intervention group adopted the group-behavior intervention, medicine treatment group adopted Clonidine slow-release patch treatment, and combined intervention group combined with the group-behavior intervention and the original therapeutic dose.(2)The investigation on the psychological health state of TD child patients and their parents: the psychological health conditions of children was evaluated by Screen for Child Anxiety Related Emotional Disorders(SCARED) and the Depression Self-rating Scale for Children(DSRSC), while the parents' was rated by Symptom Checklist-90(SCL-90).Besides, self-designed basic information questionnaire was used to probe possible influencing factors.(3) Clinical curative effect: the clinically curative effect was assessed by YGTSS.(4) Treatment security and obedience: The treatment security was assessed by Treatment Emergent Symptom Scale(TESS), and the obedience was observed during the treatment.Results:(1) The evaluation results of psychological behavior condition: According to SCARED and DSRSC, the TD child patients' total score, somatization / panic and generalized anxiety scores of SCARED were 18.43±9.32, 4.50±3.94, 4.93±3.49, which were significantly higher than those of children from normal control group(16.20±6.81, 3.49±2.03, and 3.99±2.42, with all P<0.05), while there were no significant differences in separation anxiety, social phobia, school phobia and total DSRSC scores(P>0.05). Parent SCL-90 symptom checklist: except depression factor and psychotic factor, the SCL-90 total score and other factors scores of TD child parents were significantly higher than those of parents from normal control group(P<0.05).(2) Analysis of the influential factors of TD child emotion: the most important factor influencing the TD child's anxiety emotion was disease duration, the second was the effect on their learning, with the last influential factor was the educational background of parents. There was positive correlation between phobic factors score of TD child parents and the somatization / panic and anxiety scores of TD child patients.(3) the comparison of clinical curative effect: the YGTSS reducing rate of combined intervention group at the 4th, 8th and 12 th week after intervention were 41.48±16.39,53.39±16.59,67.6±19.31, which were greater than those of behavior intervention group(33.35±17.84,43.69±22.27,55.59±22.44), and greater than those of medicine treatment group(24.79±19.94,34.49±30.79,44.13±26.57), all the differences were statistically significant(P=0.011; P<0.001; P=0.014).(4) There were no significant differences on security and obedience assessment among three groups(all P>0.05).Conclusions :(1) There were lots of psychological problems among TD child patients and their parents, such as anxiety, phobia, and so on.(2)There were obvious improvement in the symptoms and psychological health of TD child patients by specific group behavior intervention treatment, basing on clinical symptoms of TD child patients and the psychology characteristics of their parents. |
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