Ohlenschlaeger Johan, Thorup Anne, Petersen Lone, Jeppesen Pia, Køster Anne, Munkner Runa, Nordentoft Merete
Sct. Hans Hospital, Roskilde, Denmark.
Nord J Psychiatry. 2007;61(5):369-78. doi: 10.1080/08039480701644652.
Little evidence exists concerning the optimal treatment for patients with first-episode schizophrenia-spectrum disorders and the effect on traditional outcomes. The aim was to investigate whether optimal treatment models have an effect on the level of use of coercion and on traditional outcomes. Hospital-based Rehabilitation, an intensified inpatient treatment model, Integrated Treatment, an intensified model of Assertive Community Treatment, and standard treatment were compared for patients with first-episode schizophrenia-spectrum disorders. Ninety-four patients with first-episode schizophrenia-spectrum disorders estimated to benefit from long-term hospitalization were included consecutively from the Copenhagen OPUS-trial and randomized to the three treatment models. At 1-year follow-up, Hospital-based Rehabilitation and Integrated Treatment had better scores on symptoms in the negative dimension and on client satisfaction. Integrated Treatment had fewer bed-days, more patients living in non-supervised accommodation, and better score on quality of life. No differences were found as to the use of coercion. This study adds to the evidence that intensified treatment models are superior to standard treatment. A higher number of bed-days in Hospital-based Rehabilitation did not influence the effect on the outcomes measured.
关于首发精神分裂症谱系障碍患者的最佳治疗方法及其对传统预后的影响，目前证据较少。本研究旨在调查最佳治疗模式是否会对强制手段的使用程度以及传统预后产生影响。对首发精神分裂症谱系障碍患者比较了三种治疗模式：以医院为基础的康复治疗（一种强化住院治疗模式）、综合治疗（一种强化的积极社区治疗模式）和标准治疗。从哥本哈根OPUS试验中连续纳入94名预计可从长期住院治疗中获益的首发精神分裂症谱系障碍患者，并随机分配到这三种治疗模式。在1年随访时，以医院为基础的康复治疗和综合治疗在阴性症状维度及患者满意度方面得分更高。综合治疗的住院天数更少，更多患者居住在非监管住所，生活质量得分更高。在强制手段的使用方面未发现差异。该研究进一步证明强化治疗模式优于标准治疗。以医院为基础的康复治疗中较多的住院天数并未影响所测量的预后效果。
