青少年網路成癮：病例報告

Treatment of an Adolescent with Internet Addiction: A Case Report

本研究的目的在於針對網路成癮疾患(internet addiction disorder, IAD)的診斷、臨床表現、以及治療方法，特別是藥物與心理合併治療的效果，進行個案分析。個案為一位19歲未婚男性，無藥物濫用病史及精神病的家族史；經由Valproic acid與Venalfexine藥物治療及近八週的心理治療，狀況略有改善。診斷方面，網路成癮是否為一個獨特的疾病，尚有爭議；應歸類為強迫症還是衝動控制疾患，目前也尚無定論；本個案支持衝動控制的歸類。臨床表現方面，本個案在文獻所提之外，多了「逃家」的症狀表現。治療方面，本個案使用情緒安定劑合併抗鬱劑，效果不錯；加上心理治療，病患自覺心情體力均改善，顯示藥物與心理合併治療是值得嘗試的方式。另外，個案在治療上的心態是被動接受而非抗拒，因此醫護人員及家屬的積極主動對於增進病患的遵醫囑性乃至治療持續性，可能是重要的影響因素。

This paper is to analyze the diagnosis, manifestations, treatments, and especially the combining effect of pharmacotherapy and psychotherapy for Internet Addiction Disorder (IAD) through a case study. The subject studied was a 19-year-old single male without any record of drug abuse or family psychiatric history. Having taken Valproic acid and Venalfexine medications, together with a course of psychotherapy about eight weeks, the subject reported improvement in both health and behavioral condition. With regard to the diagnosis of IAD, whether it is a discrete or primary morbidity is still controversial. As for the categorization of this disorder, it is not yet settled either. However, our observation would support us to classify IAD as a subtype of impulse control disorder. In terms of manifestations, from this study we found a unique symptom: ”runaway from home”, which has not been reported in the literature. Our patient showed a favorable response to medications of mood stabilizer and antidepressant followed by psychotherapy. With improved mood and strengthened physical condition stated by the patient, the combination of pharmacotherapy and psychotherapy is evidenced as a preferential treatment. Another point noticeable in this case is that the patient showed passive, rather than resistant, attitude to treatment. Therefore, it is important that the physician and the families display initiative to help improve the compliance and treatment persistence in the patients.