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精神病患者自杀的认知行为预防:一项临床试验

The cognitive behavioural prevention of suicide in psychosis: a clinical trial.

作者信息

Tarrier Nicholas, Kelly James, Maqsood Sehar, Snelson Natasha, Maxwell Janet, Law Heather, Dunn Graham, Gooding Patricia

机构信息

Department of Psychology, Institute of Psychiatry, London, UK.

Greater Manchester West Mental Health NHS Foundation Trust, UK.

出版信息

Schizophr Res. 2014 Jul;156(2-3):204-10. doi: 10.1016/j.schres.2014.04.029. Epub 2014 May 19.

Abstract

BACKGROUND

Suicide behaviour in psychosis is a significant clinical and social problem. There is a dearth of evidence for psychological interventions designed to reduce suicide risk in this population.

AIMS

To evaluate a novel, manualised, cognitive behavioural treatment protocol (CBSPp) based upon an empirically validated theoretical model.

METHODS

A randomly controlled trial with independent and masked allocated and assessment of CBSPp with TAU (n=25, 24 sessions) compared to TAU alone (n=24) using standardised assessments. Measures of suicide probability, and suicidal ideation were the primary outcomes and measures of hopelessness, depression, psychotic symptoms, functioning, and self-esteem were the secondary outcomes, assessed at 4 and 6 months follow-up.

RESULTS

The CBSPp group improved differentially to the TAU group on two out of three primary outcome measures of suicidal ideation and suicide probability, and on secondary outcomes of hopelessness related to suicide probability, depression, some psychotic symptoms and self-esteem.

CONCLUSIONS

CBSPp is a feasible intervention which has the potential to reduce proxy measures of suicide in psychotic patients.

摘要

背景

精神病患者的自杀行为是一个重大的临床和社会问题。缺乏旨在降低该人群自杀风险的心理干预措施的证据。

目的

基于经验验证的理论模型,评估一种新颖的、手册化的认知行为治疗方案(CBSPp)。

方法

进行一项随机对照试验,将CBSPp与常规治疗(TAU,n = 25,共24次治疗)进行独立、盲法分配和评估,并与单纯TAU治疗(n = 24)进行比较,采用标准化评估。自杀可能性和自杀意念的测量是主要结局,绝望感、抑郁、精神病症状、功能和自尊的测量是次要结局,在4个月和6个月随访时进行评估。

结果

在自杀意念和自杀可能性这三项主要结局指标中的两项上,以及在与自杀可能性相关的绝望感、抑郁、一些精神病症状和自尊等次要结局方面,CBSPp组与TAU组相比有不同程度的改善。

结论

CBSPp是一种可行的干预措施,有可能降低精神病患者自杀的替代指标。

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