Times To Explore The Comprehensive Intervention Effect Of Acceptance And Commitment Therapy (ACT) On Adolescent Patients With Severe Depression Accompanied By Adverse Childhood Experiences (ACE)

purposeTo explore the comprehensive intervention effect of acceptance and commitment therapy(ACT)on adolescent patients with severe depression accompanied by adverse childhood experiences(ACE).MethodSixty adolescent patients with depression who were hospitalized in a third-class first-class hospital in Ganzhou City were selected,and the patients who met the inclusion criteria from October2021 to October 2022 were randomly divided into two groups by using the random number table method.Two groups of random numbers were read in the random number table,and the odd numbers were specified as the experimental group and the even numbers as the control group.Patients in the experimental group and the control group were given antidepressant drugs and routine nursing intervention,including health education,psychological care,cognitive intervention,etc.The experimental group was given acceptance and commitment therapy on the basis of routine treatment.ACT intervention was started in the second week after admission,and the intervention time was60～90 minutes/time,once a week,a total of 6 times.One-on-one intervention(group therapy can be considered for patients in the experimental group at the same time).The degree of depressive symptoms was assessed by Hamilton Depression Scale(HAMD),the overall well-being scale(GWB)and the cognitive style coping style questionnaire(CSQ).Data were collected before the intervention,at the 2nd week,4th week and 8th week after the intervention,and the observation indicators were measured by the researchers of the research group.Result1.The difference of demographic data shows that there is a significant gender difference by chi-square test,χ2=12.075,p=0.001;There is no significant difference in residence,χ2=2.621,p=0.105;There is no significant difference in left-behind experience,χ2=0.046,p=0.830.2.In HAMD score: The results of repeated measurement analysis of variance show that there is a significant interaction between treatment time and treatment methods(F=7.575,p<0.001),and the main effect of treatment time is significant(F=275.053,P<0.001),but the main effect of treatment methods is not significant(f = 1.806,P = 0.The results of further simple effect test showed that there was no significant difference in the total score of HAMD between the experimental group and the control group at baseline,the second week and the fourth week.At the eighth week,the total score of HAMD in the experimental group was significantly lower than that in the control group.The analysis with the treatment time as the independent variable showed that there was no significant difference in the total score of HAMD between the baseline period and the second week,but there was significant difference in the total score of HAMD between the baseline period and the fourth and eighth weeks.In the control group,there was no significant difference in the total score of HAMD between the baseline period and the second week,but there was significant difference in the total score of HAMD between the baseline period and the fourth and eighth weeks.The results of one-way ANOVA showed that there were significant differences in the total score of HAMD at different treatment time in the experimental group,with F=186.168,p<0.001 and eta2=0.828;.In the control group,there were significant differences in the total score of HAMD at different treatment time,F=82.126,p<0.001,eta2=0.680.3.In the aspect of GWB: The results of repeated measurement analysis of variance show that the interaction between treatment time and treatment mode is not significant(F=0.198,p=0.898),the main effect of treatment time is not significant(F=1.580,p=0.196),and the main effect of treatment mode is not significant(f = F=0.444,p=0.508).The results of one-way ANOVA showed that there was no significant difference in the total score of GWB at different treatment time in the experimental group,with F=0.967,p=0.411 and eta2=0.024;.In the control group,there was no significant difference in the total score of GWB at different treatment time,F=0.741,p=0.530,eta2=0.019.4.In CSQ,the results of repeated measurement analysis of variance show that the interaction between treatment time and treatment mode is significant(F=3.477,p=0.017),the main effect of treatment time is significant(F=17.882,p<0.001),and the main effect of treatment mode is significant(F=4.438,p=0.039).The results of further simple effect test showed that there was no significant difference in the total score of CSQ between the experimental group and the control group at baseline,the second week and the fourth week.At the eighth week,the total score of CSQ in the experimental group was significantly higher than that in the control group.The analysis with treatment time as the independent variable showed that there was no significant difference in the total score of CSQ between the experimental group and the second and fourth weeks,and the total score of CSQ in the baseline period was significantly lower than that in the eighth week.In the control group,there was no significant difference in the total score of CSQ between the baseline period and the second and fourth weeks,and the total score of CSQ in the baseline period was significantly lower than that in the eighth week.The results of one-way ANOVA showed that there were significant differences in the total score of CSQ at different treatment time in the experimental group,with F=16.257,p<0.001 and eta2=0.296;.In the control group,there were significant differences in the total score of CSQ at different treatment time,F=3.390,p=0.020,eta2=0.081.Conclusion1.The positive rate of adverse childhood experiences is different in gender of patients,and there is no difference in factors such as whether to stay as a child or not and growing area(rural/urban).Adolescent women are susceptible.2.Acceptance and commitment therapy has a significant effect on the intervention of severe adolescent depression with adverse childhood experiences,significantly improving the depressive symptoms and coping styles,but no significant effect on the improvement of well-being within 8weeks after treatment.3.There is a correlation between the duration of ACT treatment and the changes of depressive symptoms and coping styles of patients,but no correlation with the changes of well-being within 8weeks after treatment.