Ecole de Psychologie, Université de Moncton, Canada.
Int J Psychiatry Med. 2009;39(3):227-41. doi: 10.2190/PM.39.3.b.
Self-esteem has been identified as an important clinical variable within various psychological and psychiatric conditions. Surprisingly, its prognostic and discriminative value in predicting treatment outcome has been understudied.
The current study aims to assess, in an acute psychiatric setting, the comparative role of self-esteem in predicting treatment outcome in depression, anxiety, and global symptom severity, while controlling for socio-demographic variables, pre-treatment symptom severity, and personality pathology.
Treatment outcome was assessed with pre- and post-treatment measures.
A heterogeneous convenience sample of 63 psychiatric inpatients completed upon admission and discharge self-report measures of depression, anxiety, global symptom severity, and self-esteem.
A significant one-way repeated-measures multivariate analysis of variance (MANOVA) followed up by analyses of variance (ANOVAs) revealed significant reductions in depression (eta2 = .72), anxiety (eta2 = .55), and overall psychological distress (eta2 = .60). Multiple regression analyses suggested that self-esteem was a significant predictor of short-term outcome in depression but not for anxiety or overall severity of psychiatric symptoms. The regression model predicting depression outcome explained 32% of the variance with only pre-treatment self-esteem contributing significantly to the prediction.
The current study lends support to the importance of self-esteem as a pre-treatment patient variable predictive of psychiatric inpatient treatment outcome in relation with depressive symptomatology. Generalization to patient groups with specific diagnoses is limited due to the heterogeneous nature of the population sampled and the treatments provided. Implications for clinical practice and future research are discussed.
自尊已被确定为各种心理和精神状况的一个重要临床变量。令人惊讶的是，它在预测治疗结果方面的预后和区分价值尚未得到充分研究。
本研究旨在评估在急性精神科环境中，自尊在预测抑郁、焦虑和总体症状严重程度的治疗结果方面的相对作用，同时控制社会人口统计学变量、治疗前症状严重程度和人格病理学。
使用治疗前后的测量来评估治疗结果。
63 名精神病住院患者的异质便利样本在入院和出院时完成了抑郁、焦虑、总体症状严重程度和自尊的自我报告测量。
单因素重复测量多元方差分析（MANOVA），然后是方差分析（ANOVAs），结果显示抑郁（eta2 =.72）、焦虑（eta2 =.55）和整体心理困扰（eta2 =.60）显著降低。多元回归分析表明，自尊是抑郁短期治疗结果的一个重要预测因素，但对焦虑或总体严重程度的精神症状则不是。预测抑郁结果的回归模型仅用治疗前的自尊就能显著预测，解释了 32%的方差。
本研究支持自尊作为预测与抑郁症状相关的精神科住院治疗结果的治疗前患者变量的重要性。由于抽样人群的异质性和提供的治疗，对特定诊断患者群体的推广受到限制。讨论了对临床实践和未来研究的影响。
