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[60 岁及以上住院患者身心疾病医院治疗的结果与随访]

[Outcome and catamnesis of psychosomatic hospital treatment of 60+-year-old inpatients].

作者信息

Wolf Andreas, Hertel Guido, Schreiber-Willnow Karin, Heuft Gereon, Vandieken Roland

机构信息

Rhein-Klinik, Luisenstraße 3, 53604 Bad Honnef.

出版信息

Z Psychosom Med Psychother. 2011;57(3):251-60. doi: 10.13109/zptm.2011.57.3.251.

Abstract

OBJECTIVES

The catamnesis study examined the effectiveness of inpatient psychotherapy of patients 60+ years of age 1 to 2 years after the treatment. The patients had been treated in the years 2007 and 2008.

METHOD

Systematic pre and post inpatient treatment data were available for all patients, collected according to Psy-BaDo. For the purpose of the catamnesis the patients received the complaint questionnaire SCL-90-R as self-evaluation questionnaire, based on a shortened form of the BSI. In addition, we also used a special catamnesis questionnaire developed by the inpatient Group Therapy Research Unit staff and revised at the Rhein-Klinik (Wuchner u. Hess 2005).

RESULTS

According to their self-assessments, most patients reported of having gained a "good" to "very good" benefit from the treatment. The effectiveness of the inpatient treatment was high both at the end of the treatment and at the time of the catamnesis (discharge d = 0.86; catamnesis d = 0.84).Nearly 70 % of the patients were also later treated by outpatient psychotherapy, 51 % were prescribed psychopharmacologic drugs and 33 % other forms of medicine.

DISCUSSION

The therapeutic framework for the treatment of older patients corresponded to the rules for psychosomatic medicine and psychotherapy. There is no need for any other fundamentally different concepts. After the follow-up outpatient treatments, older patients and the therapists expressed an increased acceptance of psychotherapy. The effectiveness of treatment in older patients may result from their good resources. The results of the catamnesis show encouraging findings for the psychosomatic treatment of older patients, also in the long term from 1,5 to 2 years.

摘要

目的

本次随访研究考察了60岁及以上患者在住院治疗1至2年后住院心理治疗的效果。这些患者于2007年和2008年接受治疗。

方法

所有患者均有系统的住院治疗前后数据,这些数据是根据心理-行为诊断量表收集的。为了进行随访,患者接受了症状自评量表SCL-90-R作为自我评估问卷,该问卷基于简明症状量表的简化版。此外,我们还使用了由住院团体治疗研究单位工作人员编制并在莱茵诊所修订的特殊随访问卷(武克纳和黑斯,2005年)。

结果

根据自我评估,大多数患者报告从治疗中获得了“良好”到“非常好”的益处。住院治疗在治疗结束时和随访时的效果都很高(出院时d = 0.86;随访时d = 0.84)。近70%的患者后来还接受了门诊心理治疗,51%的患者被开了精神药物,33%的患者接受了其他形式的药物治疗。

讨论

老年患者的治疗框架符合心身医学和心理治疗的规则。不需要任何其他根本不同的概念。在随访门诊治疗后,老年患者和治疗师对心理治疗的接受度有所提高。老年患者治疗效果良好可能源于他们良好的自身条件。随访结果显示,即使在1.5至2年的长期治疗中,老年患者的心身治疗也有令人鼓舞的结果。

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