Bavo-Europoort Psychiatric Institute, Prins Constantijnweg 48-54, 3066 TA, Rotterdam, The Netherlands,
Community Ment Health J. 2013 Dec;49(6):733-41. doi: 10.1007/s10597-012-9582-2. Epub 2013 Jan 4.
In a population of dually diagnosed patients receiving assertive community treatment we used the theoretical framework of the transtheoretical model to establish (a) the proportions and characteristics of patients who were not motivated for treatment for psychiatric symptoms and substance use, (b) the proportion of patients who moved towards behavioral change after about 1 year, and examine how this change was related with clinical outcome; and (c) the sequence of change processes. Chi square tests and T tests were used to compare the patient characteristics and outcomes of patients who remained in precontemplation with those who progressed. During follow-up, 47 % of the patients came out of the precontemplation phase for treatment of psychiatric symptoms and 38 % for substance use behavior. Those who remained in precontemplation benefited less from treatment. Of those who did move forward, most appeared to become motivated for psychiatric treatment before becoming motivated to reduce substance use.
在接受积极社区治疗的双重诊断患者群体中，我们使用跨理论模型的理论框架来确定：(a) 对治疗精神症状和药物使用无动机的患者的比例和特征；(b) 大约 1 年后行为改变的患者比例，以及检查这种变化与临床结果的关系；(c) 变化过程的顺序。卡方检验和 T 检验用于比较仍处于前思考阶段的患者和进展阶段的患者的特征和结果。在随访期间，47%的患者开始接受精神症状的治疗，38%的患者开始接受药物使用行为的治疗。那些仍处于前思考阶段的患者从治疗中获益较少。在那些确实向前迈进的人中，大多数人在开始减少药物使用之前似乎对精神治疗更有动力。
