St Bartholomew's Hospital, East London Foundation Trust, West Smithfield, London EC1A 7BE, UK.
Br J Psychiatry. 2010 Aug;197(2):91-5. doi: 10.1192/bjp.bp.109.066894.
The value of drug interviews in the treatment of conversion disorder is at present unknown.
To review all the available papers published in English that report on the use of drug interviews for treating conversion/dissociative disorder.
Databases (including EMBASE, MEDLINE and PsycINFO) were searched from 1920 to 2009. Selected publications had to report on the use of drug interviews in people diagnosed with a conversion/dissociative disorder. Qualitative and quantitative data were extracted. Predictors of a positive response were ascertained using meta-analytic techniques.
Fifty-five papers meeting inclusion criteria were identified. No studies compared the intervention with a suitable control group. However, two studies reported high response rates when drug interview was used in individuals with treatment-resistant conversion disorder. In the meta-analysis, the use of suggestion and occurrence of emotional catharsis during the interview were positively associated with recovery. Combining two medications and comorbid psychiatric disorder were negatively associated with recovery.
The evidence for effectiveness of drug interviews is of poor quality but it may be of benefit in the treatment of acute and treatment-resistant conversion disorder. A proactive approach during the interview, making suggestions the individual will respond, could influence outcome. Comorbid psychiatric disorder should be treated conventionally. Experimental studies to determine efficacy are required.
目前尚不清楚药物访谈在转换障碍治疗中的价值。
回顾所有以英文发表的报告药物访谈用于治疗转换/分离障碍的可用论文。
从 1920 年至 2009 年，检索数据库（包括 EMBASE、MEDLINE 和 PsycINFO）。入选的出版物必须报告在诊断为转换/分离障碍的人群中使用药物访谈的情况。提取定性和定量数据。使用荟萃分析技术确定阳性反应的预测因素。
确定了符合纳入标准的 55 篇论文。没有研究将干预与合适的对照组进行比较。然而，有两项研究报告了在治疗抵抗性转换障碍患者中使用药物访谈时的高反应率。荟萃分析中，访谈过程中使用暗示和情感宣泄与恢复呈正相关。联合使用两种药物和合并精神科疾病与恢复不良呈负相关。
药物访谈有效性的证据质量较差，但它可能对急性和治疗抵抗性转换障碍的治疗有益。访谈过程中的积极主动方法，提出个体将做出反应的建议，可能会影响结果。合并的精神科疾病应常规治疗。需要进行确定疗效的实验研究。
