Biancosino Bruno, Rocchi Denis, Donà Silvia, Kotrotsiou Vasiliki, Marmai Luciana, Grassi Luigi
Section of Psychiatry, Department of Medical Sciences of Communication and Behavior, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy.
Eur Psychiatry. 2006 Oct;21(7):460-2. doi: 10.1016/j.eurpsy.2005.03.005. Epub 2005 Jun 17.
Insomnia in psychiatric patients is frequently underestimated in clinical practice. Usually drugs are prescribed for the treatment of this disorder but non-pharmacological intervention can be successfully used. The present study aimed at evaluating the efficacy of a two-session psychoeducational intervention in improving persistent non-organic insomnia and reducing the administration of PRN therapy in severely mentally ill patients. A pre-post study was performed on 36 psychiatric patients admitted to a residential psychiatric unit. The Nocturnal Sleep Onset Scale (NSOS) and Daytime Sleepiness Scale (DSS), the sleep onset latency, the time awake after sleep onset and the numbers of awakenings were gathered 2 weeks before the intervention (T0), immediately prior the intervention (T1), 2 weeks after the last session of the intervention (T2) and a 3-month follow-up (T3). The total number of administrations of PRN therapy from T0 to T1 and from T1 to T2 were also examined. A significant reduction was shown on the NSOS, the sleep onset latency and in the time awake after sleep onset from T1 to T2 and from T1 to T3, while no significant difference was found between T0 and T1. A significant decrease on the mean number of administrations of PRN therapy was also found between 15 days before the intervention (T0-T1) and 15 days after intervention (T1-T2). The initial results of this study seems to suggest the possible efficacy of a short-term psychoeducational intervention on improving persistent non-organic insomnia in severely mentally ill patients. Further control studies are necessary to confirm these findings.
在临床实践中，精神病患者的失眠问题常常被低估。通常会开药物来治疗这种病症，但非药物干预也可以成功应用。本研究旨在评估两阶段心理教育干预对改善重度精神疾病患者持续性非器质性失眠以及减少按需治疗药物（PRN）使用的效果。对入住一家住院精神科病房的36名精神病患者进行了一项前后对照研究。在干预前2周（T0）、干预即将开始前（T1）、干预最后一次疗程后2周（T2）以及3个月随访时（T3），收集夜间睡眠起始量表（NSOS）、日间嗜睡量表（DSS）、睡眠起始潜伏期、睡眠起始后觉醒时间以及觉醒次数。还检查了从T0到T1以及从T1到T2的按需治疗药物的总使用次数。从T1到T2以及从T1到T3，NSOS、睡眠起始潜伏期以及睡眠起始后觉醒时间均有显著降低，而T0和T1之间未发现显著差异。在干预前15天（T0 - T1）和干预后15天（T1 - T2）之间，按需治疗药物的平均使用次数也有显著减少。本研究的初步结果似乎表明，短期心理教育干预可能对改善重度精神疾病患者的持续性非器质性失眠有效。需要进一步的对照研究来证实这些发现。
