Turner M A, Boden J M, Smith-Hamel C, Mulder R T
Totara House Early Intervention for Psychosis Service, Canterbury District Health Board, Christchurch, New Zealand.
Acta Psychiatr Scand. 2009 Aug;120(2):129-37. doi: 10.1111/j.1600-0447.2009.01386.x. Epub 2009 Mar 31.
To examine: i) changes in key outcome measures over time in treatment in a representative first-episode psychosis treatment cohort and ii) baseline predictors of service disengagement.
Baseline characteristics of 236 patients were examined for associations with outcomes over time using generalized estimating equation models. The data on disengagement were analysed using logistic regression.
After controlling for admission scores, patients showed consistently improved outcomes while in treatment on functional recovery (unemployment, P < 0.01; HoNOS, P < 0.001; the Quality of Life Scale, P < 0.001; GAF, P < 0.05) but not symptomatology (as assessed by the PANSS and substance abuse). The 64 (33%) who disengaged were more likely to be unemployed (P < 0.01) and have higher HoNOS (P < 0.01) and GAF (P < 0.05) scores at baseline.
This evaluation has shown significant improvements in psychosocial functioning but not psychopathology during treatment at an Early Intervention for Psychosis Service. Despite attempts to retain patients, there is a high rate of treatment discontinuation.
研究:i)在一个具有代表性的首发精神病治疗队列中,治疗期间关键结局指标随时间的变化;ii)治疗中断的基线预测因素。
使用广义估计方程模型,检查236名患者的基线特征与随时间变化的结局之间的关联。使用逻辑回归分析治疗中断的数据。
在控制入院分数后,患者在治疗期间功能恢复方面(失业情况,P<0.01;健康与社会需求评分,P<0.001;生活质量量表,P<0.001;总体功能评估,P<0.05)持续显示出改善,但症状学方面(通过阳性和阴性症状量表及药物滥用评估)无改善。64名(33%)中断治疗的患者在基线时更可能失业(P<0.01),且健康与社会需求评分(P<0.01)和总体功能评估(P<0.05)得分更高。
该评估显示,在精神病早期干预服务的治疗期间,社会心理功能有显著改善,但精神病理学方面无改善。尽管努力挽留患者,但治疗中断率仍很高。