Mueser Kim T, Meyer Piper S, Penn David L, Clancy Richard, Clancy Donna M, Salyers Michelle P
Department of Psychiatry, Dartmouth Medical School, Concord, New Hampshire 03301, USA.
Schizophr Bull. 2006 Oct;32 Suppl 1(Suppl 1):S32-43. doi: 10.1093/schbul/sbl022. Epub 2006 Aug 9.
The Illness Management and Recovery (IMR) program was developed based on a comprehensive review of research on teaching illness self-management strategies to clients with schizophrenia and other severe mental illnesses and "packaged" in a resource kit to facilitate dissemination. Despite growing dissemination of this program, it has not yet been empirically validated. This article describes the development and theoretical underpinnings of the IMR program and presents pilot data from the United States and Australia (N = 24, 88% schizophrenia or schizoaffective) on the effects of individual-based and group-based treatment over the 9-month program and over a 3-month follow-up. High satisfaction was reported by participants. Strong improvements over treatment and at follow-up were found in clients' self-reported effectiveness in coping with symptoms and clinicians' reports of global functioning and moderate improvements in knowledge about mental illness, distress related to symptoms, hope, and goal orientation. These findings support the feasibility and promise of the IMR program and point to the need for controlled research to rigorously evaluate its effects.
疾病管理与康复(IMR)项目是在对向精神分裂症及其他严重精神疾病患者传授疾病自我管理策略的研究进行全面综述的基础上开发的,并“打包”成一个资源包以促进传播。尽管该项目的传播日益广泛,但尚未得到实证验证。本文描述了IMR项目的开发过程和理论基础,并展示了来自美国和澳大利亚的试点数据(N = 24,88%为精神分裂症或分裂情感性障碍),这些数据涉及在为期9个月的项目及3个月随访期间基于个体和基于小组的治疗效果。参与者报告了较高的满意度。在治疗期间及随访时,发现患者自我报告的应对症状的有效性、临床医生报告的整体功能有显著改善,且在关于精神疾病的知识、与症状相关的痛苦、希望和目标导向方面有适度改善。这些发现支持了IMR项目的可行性和前景,并指出需要进行对照研究以严格评估其效果。