Meister K, Rietschel L, Burlon M, Gouzoulis-Mayfrank E, Bock T, Lambert M
Psychosen-Ersterkennungs- und Behandlungsprojekt, Klinik für Psychiatrie und Psychotherapie, Zentrum für Psychosoziale Medizin, Universitätskrankenhaus Hamburg-Eppendorf.
Fortschr Neurol Psychiatr. 2010 Feb;78(2):90-100. doi: 10.1055/s-0028-1109979. Epub 2010 Feb 9.
Despite the high prevalence of comorbid substance use disorders (SUD) in young schizophrenic patients and the association of persisting SUD and poor outcome, there are only few randomized controlled psychological treatment studies in this special dual diagnosis group available. According to therapeutic recommendations, efficient treatment models need to integrate traditional psychiatric therapy and therapy of addiction offered in one setting. Short-term interventions have adapted Motivational interviewing (MI) for dual diagnosis, which has been shown to be effective among other substance abuse disorders. However a recent Cochrane review showed that insufficient evidence exists to show that any psychosocial treatment method for dual diagnosis is superior to others. The aim of this review was to assess the current evidence for the efficacy of psychosocial interventions for reducing substance in young patients with psychosis. Five randomized-controlled studies were identified. This review did not find any specific psychosocial intervention that had been replicated and consistently showed clear advantages over comparison condition for substance-related and other psychiatric outcomes.
尽管年轻精神分裂症患者中合并物质使用障碍（SUD）的患病率很高，且持续存在的SUD与不良预后相关，但针对这一特殊双重诊断群体的随机对照心理治疗研究却很少。根据治疗建议，有效的治疗模式需要在同一环境中整合传统的精神科治疗和成瘾治疗。短期干预采用了针对双重诊断的动机性访谈（MI），该方法在其他物质滥用障碍中已被证明是有效的。然而，最近一项Cochrane综述表明，没有足够的证据表明任何针对双重诊断的心理社会治疗方法优于其他方法。本综述的目的是评估当前关于心理社会干预对减少年轻精神病患者物质使用疗效的证据。共确定了五项随机对照研究。本综述未发现任何特定的心理社会干预措施得到重复验证，且在与物质使用相关及其他精神科结局方面始终显示出比对照条件更明显的优势。
