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精神分裂症治疗中的心理教育与依从性:慕尼黑精神病信息项目研究结果

Psychoeducation and compliance in the treatment of schizophrenia: results of the Munich Psychosis Information Project Study.

作者信息

Pitschel-Walz Gabriele, Bäuml Josef, Bender Wolfram, Engel Rolf R, Wagner Michael, Kissling Werner

机构信息

Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany.

出版信息

J Clin Psychiatry. 2006 Mar;67(3):443-52. doi: 10.4088/jcp.v67n0316.

Abstract

OBJECTIVE

The present study examined whether psychoeducational groups for patients with schizophrenic disorders and for their families can reduce rehospitalization rates and improve compliance.

METHOD

236 inpatients who met DSM-III-R criteria for schizophrenia or schizoaffective disorder and who had regular contact with at least 1 relative or other key person were randomly assigned to 1 of 2 treatment conditions. In the intervention condition, patients and their relatives were encouraged to attend psychoeducational groups over a period of 4 to 5 months. The patients' and relatives' psychoeducational programs were separate, and each consisted of 8 sessions. Patients in the other treatment condition received routine care. Outcomes were compared over 12-month and 24-month follow-up periods. The study was conducted from 1990 to 1994.

RESULTS

It was possible to significantly reduce the rehospitalization rate after 12 and 24 months in patients who attended psychoeducational groups compared with those receiving routine care (p < .05). Patients who attended psychoeducational groups showed better compliance than patients under routine care without psycho-education.

CONCLUSIONS

The results suggest that a relatively brief intervention of 8 psychoeducational sessions with systematic family involvement in simultaneous groups can considerably improve the treatment of schizophrenia. Psychoeducation should be routinely offered to all patients with schizophrenia and their families.

摘要

目的

本研究探讨针对精神分裂症患者及其家属的心理教育小组是否能够降低再住院率并提高依从性。

方法

236名符合DSM-III-R精神分裂症或分裂情感性障碍标准且与至少1名亲属或其他关键人物有定期联系的住院患者被随机分配到两种治疗条件中的一种。在干预组中,鼓励患者及其亲属在4至5个月的时间内参加心理教育小组。患者和亲属的心理教育项目是分开的,每个项目包括8次课程。另一种治疗条件下的患者接受常规护理。在12个月和24个月的随访期内对结果进行比较。该研究于1990年至1994年进行。

结果

与接受常规护理的患者相比,参加心理教育小组的患者在12个月和24个月后再住院率显著降低(p < .05)。参加心理教育小组的患者比未接受心理教育的常规护理患者表现出更好的依从性。

结论

结果表明,在系统的家庭参与下同时进行8次心理教育课程的相对简短干预可以显著改善精神分裂症的治疗。应将心理教育常规提供给所有精神分裂症患者及其家属。

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