体心理治疗治疗精神分裂症阴性症状的有效性和成本效益：一项多中心随机对照试验。
Effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia--a multi-centre randomised controlled trial.
机构信息
Unit for Social and Community Psychiatry, Queen Mary University of London, Newham Centre for Mental Health, London E13 8SP, UK.
出版信息
BMC Psychiatry. 2013 Jan 14;13:26. doi: 10.1186/1471-244X-13-26.
BACKGROUND
Negative symptoms of schizophrenia are frequently associated with poor long term outcomes. Established interventions have little, if any, positive effects on negative symptoms. Arts Therapies such as Body Psychotherapy (BPT) have been suggested to reduce negative symptoms, but the existing evidence is limited. In a small exploratory trial a manualised form of group BPT led to significantly lower negative symptom levels both at the end of treatment and at 4 months follow-up as compared to supportive counseling. We designed a large multi-site trial to assess the effectiveness of a manualised BPT intervention in reducing negative symptoms, compared to an active control.
METHODS/DESIGN: In a randomised controlled trial, 256 schizophrenic outpatients with negative symptoms will be randomly allocated either to BPT or Pilates groups. In both conditions, patients will be offered two 90 minutes sessions per week in groups of about 8 patients over a period of 10 weeks. Outcomes are assessed at the end of treatment and at six months follow-up. The primary outcome is severity of negative symptoms, as measured by the Positive and Negative Symptom Scale (PANSS), whilst a range of secondary outcome measures include general psychopathology, social contacts, and quality of life. We will also assess the cost-effectiveness of the intervention.
DISCUSSION
The study aims to evaluate the effectiveness of a promising form of group therapy which may help alleviate negative symptoms that are associated with unfavourable long-term outcomes and have so far been difficult to treat. If the trial is successful, it will add a new and effective option in the treatment of negative symptoms. Group BPT is manualised, might be attractive to many patients because of its unusual approach, and could potentially be rolled out to services at relatively little additional cost.
TRIAL REGISTRATION
Current Controlled Trials ISRCTN84216587.
背景
精神分裂症的阴性症状常与不良的长期预后相关。现有的干预措施对阴性症状几乎没有积极影响。有研究提出艺术治疗，如身体心理疗法（BPT），可降低阴性症状，但现有证据有限。在一项小型探索性试验中，与支持性咨询相比，一种规范化的团体 BPT 形式可显著降低治疗结束时和 4 个月随访时的阴性症状水平。我们设计了一项大型多中心试验，以评估规范化 BPT 干预与积极对照相比降低阴性症状的效果。
方法/设计：在一项随机对照试验中，256 名有阴性症状的精神分裂症门诊患者将被随机分配到 BPT 或 Pilates 组。在两种情况下，患者将在 10 周内每周接受两次 90 分钟的小组治疗，每组约 8 名患者。结果在治疗结束时和 6 个月随访时进行评估。主要结局是用阳性和阴性症状量表（PANSS）测量的阴性症状严重程度，同时还包括一般精神病学、社会联系和生活质量等一系列次要结局指标。我们还将评估干预措施的成本效益。
讨论
该研究旨在评估一种有前途的团体治疗形式的有效性，这种形式可能有助于缓解与不良长期预后相关且迄今难以治疗的阴性症状。如果试验成功，它将为治疗阴性症状提供一种新的有效选择。团体 BPT 是规范化的，因其独特的方法可能对许多患者具有吸引力，并可能以相对较低的额外成本在服务中推广。
试验注册
当前对照试验 ISRCTN84216587。
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