University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
Schizophr Bull. 2011 Sep;37 Suppl 2(Suppl 2):S71-9. doi: 10.1093/schbul/sbr072.
Standardized recovery criteria go beyond symptom remission and put special emphasis on personal and social functioning in residence, work, and leisure. Against this background, evidence-based integrated approaches combining cognitive remediation with social skills therapy show promise for improving functional recovery of schizophrenia patients. Over the past 30 years, research groups in 12 countries have evaluated integrated psychological therapy (IPT) in 36 independent studies. IPT is a group therapy program for schizophrenia patients. It combines neurocognitive and social cognitive interventions with social skills and problem-solving approaches. The aim of the present study was to update and integrate the growing amount of research data on the effectiveness of IPT. We quantitatively reviewed the results of these 36 studies, including 1601 schizophrenia patients, by means of a meta-analytic procedure. Patients undergoing IPT showed significantly greater improvement in all outcome variables (neurocognition, social cognition, psychosocial functioning, and negative symptoms) than those in the control groups (placebo-attention conditions and standard care). IPT patients maintained their mean positive effects during an average follow-up period of 8.1 months. They showed better effects on distal outcome measures when all 5 subprograms were integrated. This analysis summarizes the broad empirical evidence indicating that IPT is an effective rehabilitation approach for schizophrenia patients and is robust across a wide range of sample characteristics as well as treatment conditions. Moreover, the cognitive and social subprograms of IPT may work in a synergistic manner, thereby enhancing the transfer of therapy effects over time and improving functional recovery.
标准化的康复标准不仅仅关注症状缓解,还特别强调居住、工作和休闲方面的个人和社会功能。在此背景下,结合认知矫正和社交技能治疗的循证综合方法有望改善精神分裂症患者的功能康复。在过去的 30 年中,12 个国家的研究小组在 36 项独立研究中评估了综合心理治疗(IPT)。IPT 是一种针对精神分裂症患者的团体治疗计划。它将神经认知和社会认知干预与社交技能和解决问题的方法相结合。本研究的目的是更新和整合越来越多关于 IPT 有效性的研究数据。我们通过元分析程序定量地审查了这些 36 项研究的结果,其中包括 1601 名精神分裂症患者。与对照组(安慰剂-注意条件和标准护理)相比,接受 IPT 的患者在所有结果变量(神经认知、社会认知、心理社会功能和阴性症状)方面都有显著的改善。IPT 患者在平均 8.1 个月的随访期间保持了他们的平均积极效果。当整合所有 5 个子程序时,他们对远程结果测量的效果更好。这项分析总结了广泛的经验证据,表明 IPT 是一种有效的精神分裂症患者康复方法,在广泛的样本特征和治疗条件下具有稳健性。此外,IPT 的认知和社会子程序可能以协同方式发挥作用,从而随着时间的推移增强治疗效果的转移,并改善功能康复。