Rowe Michael, Bellamy Chyrell, Baranoski Madelon, Wieland Melissa, O'Connell Maria J, Benedict Patricia, Davidson Larry, Buchanan Josephine, Sells Dave
Department of Psychiatry, Yale School of Medicine, 319 Peck St., Building 6W, Suite 1C, New Haven, CT 06513, USA.
Psychiatr Serv. 2007 Jul;58(7):955-61. doi: 10.1176/ps.2007.58.7.955.
This study compared the effectiveness of two interventions in reducing alcohol use, drug use, and criminal justice charges for persons with severe mental illnesses: first, a community-oriented group intervention with citizenship training and peer support that was combined with standard clinical treatment, including jail diversion services, and second, standard clinical treatment with jail diversion services alone.
A total of 114 adults with serious mental illness participated in a 2 x 3 prospective longitudinal, randomized clinical trial with two levels of intervention (group and peer support for the experimental condition and standard services for the control) and three interviews (baseline, six months, and 12 months). Self-report questionnaires assessed alcohol and drug use, and program databases assessed criminal justice contacts. The authors used a mixed-models analysis to assess alcohol and drug use, repeated-measures analysis of covariance to assess criminal justice charges, and correlational analyses to assess the relation between intervention participation and outcome variables.
The experimental group showed significantly reduced alcohol use in comparison with the control group. Further, results showed a significant group-by-time interaction, where alcohol use decreased over time in the experimental group and increased in the control group. Drug use and criminal justice charges decreased significantly across assessment periods in both groups.
Of the outcomes, only decreased alcohol use was attributable to the experimental intervention. Although this may be a chance finding, peer- and community-oriented group support and learning may facilitate decreased alcohol use over time.
本研究比较了两种干预措施对患有严重精神疾病者减少酒精使用、药物使用及刑事司法指控的有效性：第一种是面向社区的团体干预，包括公民身份培训和同伴支持，并结合标准临床治疗，其中包括监狱转处服务；第二种是仅提供监狱转处服务的标准临床治疗。
共有114名患有严重精神疾病的成年人参与了一项2×3前瞻性纵向随机临床试验，该试验有两个干预水平（实验组为团体和同伴支持，对照组为标准服务）以及三次访谈（基线、六个月和十二个月）。自我报告问卷评估酒精和药物使用情况，项目数据库评估刑事司法接触情况。作者使用混合模型分析来评估酒精和药物使用情况，使用重复测量协方差分析来评估刑事司法指控，并使用相关分析来评估干预参与与结果变量之间的关系。
与对照组相比，实验组的酒精使用显著减少。此外，结果显示出显著的组×时间交互作用，即实验组的酒精使用随时间减少，而对照组则增加。两组在各评估期内的药物使用和刑事司法指控均显著下降。
在各项结果中，只有酒精使用的减少可归因于实验性干预。尽管这可能是一个偶然发现，但同伴和社区导向的团体支持与学习可能会随着时间的推移促进酒精使用的减少。
