Malmberg L, Fenton M
Department of Psychiatry/ Rehabilitation Unit, Porvoo Hospital, Sairaalantie 2, Porvoo, Finland, FIN-06200.
Cochrane Database Syst Rev. 2000(2):CD001360. doi: 10.1002/14651858.CD001360.
People with schizophrenia and severe mental illness may need much support from health care professionals, in most cases over a long period of time. Research on the effects of psychotherapy for schizophrenia shows mixed results. Although pharmacological interventions remain the treatment of choice for schizophrenia patients, it is also of interest to look at the effects of treatment methods focusing on psychosocial factors affecting schizophrenia.
To review the effects of individual psychodynamic psychotherapy and/or psychoanalysis for people with schizophrenia or severe mental illness.
Electronic searches of Biological Abstracts (1985-1999), CINAHL (1982-1999), The Cochrane Library CENTRAL (Issue 1, 1999), The Cochrane Schizophrenia Group's Register (1999), Dissertation Abstracts On disc (1866-1999), EMBASE (1980-1999), MEDLINE (1966-1999), PsycLIT (1974-1999), and Sociofile (1974-1998) were made. Authors of included trials were contacted for information on further trials.
All randomised trials of individual psychodynamic psychotherapy or psychoanalysis for people with schizophrenia or severe mental illness (however defined) were selected.
Data were independently extracted by at least two reviewers. For dichotomous data relative risks (RR) were calculated and for continuous data weighted mean differences (WMD) between groups were calculated.
No trials of a psychoanalytic approach were identified. Data are sparse for all comparisons involving a psychodynamic approach. There is no evidence of any positive effect of psychodynamic therapy and the possibility of adverse effects seems never to have been considered. The psychodynamic approach may be more acceptable to people than a more cognitive reality-adaptive therapy.
REVIEWER'S CONCLUSIONS: Current data do not support the use of psychodynamic psychotherapy techniques for hospitalised people with schizophrenia. If psychoanalytic therapy is being used for people with schizophrenia there is an urgent need for trials.
精神分裂症患者及患有严重精神疾病的人可能需要医护专业人员的大量支持，多数情况下这种支持是长期的。关于精神分裂症心理治疗效果的研究结果不一。虽然药物干预仍是精神分裂症患者的首选治疗方法，但关注影响精神分裂症的社会心理因素的治疗方法的效果也值得研究。
综述个体精神动力心理治疗和/或精神分析对精神分裂症患者或患有严重精神疾病的人的效果。
对《生物学文摘》（1985 - 1999年）、护理学与健康领域数据库（1982 - 1999年）、考科蓝图书馆中央数据库（1999年第1期）、考科蓝精神分裂症研究组注册库（1999年）、《学位论文文摘光盘版》（1866 - 1999年）、《荷兰医学文摘数据库》（1980 - 1999年）、《医学索引》（1966 - 1999年）、《心理学文摘》（1974 - 1999年）和《社会科学文献数据库》（1974 - 1998年）进行了电子检索。与纳入试验的作者联系以获取更多试验的信息。
选取所有针对精神分裂症患者或患有严重精神疾病的人（无论如何定义）进行个体精神动力心理治疗或精神分析的随机试验。
数据由至少两名评审员独立提取。对于二分数据，计算相对危险度（RR）；对于连续数据，计算组间加权均数差（WMD）。
未发现精神分析方法的试验。所有涉及精神动力方法的比较的数据都很稀少。没有证据表明精神动力疗法有任何积极效果，而且似乎从未考虑过其产生不良反应的可能性。精神动力方法可能比更具认知现实适应性的疗法更容易被人们接受。
目前的数据不支持对住院的精神分裂症患者使用精神动力心理治疗技术。如果对精神分裂症患者使用精神分析疗法，则迫切需要进行试验。
