Department of Psychiatry, University of Saskatchewan, 103 Hospital Dr., Saskatoon, Saskatchewan, S7N 0W8, Canada.
Psychiatr Serv. 2012 Mar;63(3):216-22. doi: 10.1176/appi.ps.20110013.
Specialized early intervention by a team providing assertive community treatment (ACT) is beneficial to the recovery, housing, and employment of individuals with schizophrenia, but few studies have examined its effect on social support. This study assessed whether the ACT model of care was related to clinical and social outcomes among patients who had experienced a first episode of psychosis.
The sample was drawn from the Lambeth Early Onset Trial, a study of 144 patients in the United Kingdom who sought treatment for a first episode of psychosis between January 2000 and October 2001 and who were randomly assigned to a specialized early intervention modeled on ACT or standard care. The Positive and Negative Syndrome Scale, the Global Assessment of Functioning, and the Significant Others Scale were administered at six-month and 18-month follow-ups.
Data on social support were available at both follow-ups for 57 patients assigned to specialized care and 50 patients assigned to standard care. The two groups were similar in personal characteristics, relationship status, and living arrangements at baseline and at six-month follow-up, but by 18 months, patients in specialized care reported having a higher mean±SD number of significant others in their social networks than did standard care patients (2.40±1.20 and 1.71±1.06, respectively; p=.01). They also achieved superior clinical outcomes at 18 months, and these outcomes were associated with network size.
Early intervention by using an ACT model of care may improve clinical results by reestablishing or maintaining bonds between patients and family, friends, and acquaintances.
由提供坚定社区治疗（ACT）的团队进行的专业早期干预有益于精神分裂症患者的康复、住房和就业，但很少有研究探讨其对社会支持的影响。本研究评估了 ACT 护理模式是否与经历首发精神病患者的临床和社会结局有关。
该样本来自兰贝斯早期发作试验，该试验研究了 144 名在 2000 年 1 月至 2001 年 10 月期间因首发精神病而寻求治疗的英国患者，他们被随机分配到专门的早期干预模式，该模式以 ACT 为模型或标准护理。在六个月和 18 个月的随访中，对阳性和阴性综合征量表、总体功能评估和重要他人量表进行了评估。
在随访的六个月和 18 个月时，分别有 57 名接受专门护理的患者和 50 名接受标准护理的患者提供了社会支持数据。两组患者在个人特征、关系状况和居住安排方面在基线和六个月随访时相似，但在 18 个月时，接受专门护理的患者报告其社会网络中有更多的重要他人，平均值±标准差分别为 2.40±1.20 和 1.71±1.06（p=.01）。他们在 18 个月时也取得了更好的临床结果，这些结果与网络规模相关。
使用 ACT 护理模式的早期干预可能通过重新建立或维持患者与家人、朋友和熟人之间的联系来改善临床结果。
