Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium.
Eur Addict Res. 2014;20(3):105-14. doi: 10.1159/000355267. Epub 2013 Oct 31.
This review provides evidence of which interventions need to be part of effective outpatient integrated treatment for patients with comorbid schizophrenia and substance use disorders.
A total of 14 randomized controlled trials were included. Effect sizes are provided to assess the magnitude of the treatments' efficacy.
Despite the studies' heterogeneity, we can conclude that certain programs (e.g. Behavioral Treatment for Substance Abuse in Severe and Persistent Mental Illness ) and specific interventions (e.g. motivational interviewing, family interventions) seem to be effective. Moreover, programs integrating multiple interventions are more likely to be positively related to better outcomes than single interventions. Finally, the lack of difference between effect sizes of assertive community treatment compared to case management suggests that a lower caseload is not necessary for positive treatment outcomes.
Integrated treatment seems advantageous, although effect sizes are mostly modest. More homogeneous and qualitative sound studies are needed.
本综述旨在为伴有精神分裂症和物质使用障碍共病的患者提供有效的门诊综合治疗中需要包含哪些干预措施的证据。
共纳入了 14 项随机对照试验。提供了效应量来评估治疗效果的大小。
尽管研究存在异质性，但我们可以得出结论，某些方案（例如严重和持续精神疾病的物质滥用行为治疗）和特定干预措施（例如动机性访谈、家庭干预）似乎是有效的。此外，整合多种干预措施的方案比单一干预措施更有可能与更好的结果相关。最后，与个案管理相比，积极社区治疗的效应量之间没有差异表明，积极的治疗结果并不需要较低的病例量。
尽管效应量大多适中，但综合治疗似乎具有优势。需要更多同质和高质量的研究。
