Abstract: Background　The detection rate of adolescent depression has shown an increasing trend，which has become a public issue in society. Currently，there are still limited treatment options. ACT is one of the core representatives of the third-generation cognitive behavioral therapy（CBT），and its application in domestic adolescent populations is relatively limited. Objective　This study aims to explore the intervention effects of ACT combined with Sertraline on depressive mood， suicidal ideation，and sleep quality of adolescents with depression. Methods　Adolescents with depression who visited Chenjiaqiao Hospital in Shapingba District，Chongqing，from October 2023 to April 2024 were selected as the research subjects.A total of 70 patients were initially included and divided into a control group（n=35） and an intervention group（n=35） using a randomized controlled trial. The control group used Sertraline combined with mental health education，while the intervention group used ACT combined with Sertraline. The clinical efficacy of the two groups was compared using the Athens Insomnia Scale（AIS），Self-rating Depression Scale（SDS），Self-rating Idea of Suicide Scale（SIOSS），Acceptance and Action Questionnaire- Ⅱ（AAQ- Ⅱ ），Avoidance and Fusion Questionnaire for Youth（AFQ-Y8），and sleep monitoring results. Results　Finally，30 patients in the control group and 32 in the intervention group completed the study. After 8 weeks of treatment，AIS，SDS，SIOSS，AAQ- Ⅱ，and AFQ-Y8 score of the intervention group was lower than that of the control group （P<0.05）. Total sleep time（TST） and Sleep efficiency（SE） were higher in the intervention group（P<0.05）； and Sleep latency（SL） and Wake after sleep onset（WASO） were lower in the intervention group（P<0.05）. Conclusion　ACT can increase psychological flexibility，alleviate depressive mood，improve sleep quality，and reduce suicidal ideation levels in adolescents with depression，which is of good clinical application value.

Key words: Depressive disorder, Adolescent, Acceptance and commitment therapy, Sertraline, Suicidal ideation, Sleep quality, Psychological flexibility, Randomized controlled trial

摘要： 背景　青少年抑郁症的检出率呈增长趋势，已成为社会公共问题，现有治疗方法仍较局限。接纳承诺疗法（ACT）是第三代认知行为疗法核心代表之一，在国内青少年群体中的应用较局限。目的　了解ACT联合舍曲林对青少年抑郁症患者抑郁情绪、自杀意念和睡眠质量的干预效果。方法　选取2023年10月—2024年4月就诊于重庆市沙坪坝区陈家桥医院的青少年抑郁症患者为研究对象（n=70），随机对照试验，分为对照组（n=35）和干预组（n=35）。对照组采用心理健康教育联合舍曲林进行干预，干预组采用ACT联合舍曲林进行干预，干预时间为8周。通过两组干预前后的阿森斯失眠量表（AIS）、抑郁自评量表（SDS）、自杀意念自评量表（SIOSS）、接纳与行动问卷（AAQ-Ⅱ）、青少年回避与融合问卷（AFQ-Y8）及睡眠监测结果来比较两组的临床疗效。结果　最终对照组30例、干预组32例完成研究。经过8周治疗后，干预组的AIS、SDS、SIOSS、AAQ-Ⅱ、AFQ-Y8评分低于对照组（P<0.05）；睡眠总时间（TST）、睡眠效率（SE）高于对照组（P<0.05），睡眠潜伏期（SL）和觉醒时间（WASO）低于对照组（P<0.05）。结论　ACT能增加青少年抑郁症患者的心理灵活性，缓解抑郁情绪，改善睡眠质量，降低自杀意念水平，具有较好的临床运用价值。

关键词: 抑郁症, 青少年, 接纳与承诺疗法, 舍曲林, 自杀意念, 睡眠质量, 心理灵活性, 随机对照试验