de Waal Marleen M, Kikkert Martijn J, Blankers Matthijs, Dekker Jack J M, Goudriaan Anna E
Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
BMC Psychiatry. 2015 Oct 29;15:267. doi: 10.1186/s12888-015-0652-1.
Psychiatric patients are more likely to be victims of crime than others in the community. Dual diagnosis patients with comorbid psychiatric and substance use disorders are especially prone to victimization. Victimization is associated with substance abuse, more severe symptomatology and homelessness. There is a strong need for interventions to reduce victimization in this population. We developed the Self-wise, Other-wise, Streetwise (SOS) training to reduce victimization in patients with dual diagnosis.
METHODS/DESIGN: This study is a randomized controlled trial using a parallel group design to determine the effectiveness of adding the SOS training to care as usual. Patients with dual diagnosis (N = 250) will be allocated to either care as usual plus SOS training (N = 125) or care as usual only (N = 125) using computer-generated stratified block randomization. To compare effectiveness participants will be interviewed at baseline and 2, 8 and 14 months follow-up. The primary outcome measure is treatment response (yes/no), defined as either no victimization at 14 months follow-up or at least a 50% reduction in incidents of victimization at 14 months follow-up compared to baseline assessment. Victimization is measured with the Safety Monitor, an adequate self-report instrument used by Statistics Netherlands to measure victimization on a large scale in the Netherlands. Outcome assessors are blind to treatment allocation. An economic evaluation will be performed alongside the randomized controlled trial and will take the societal perspective.
This study is the first randomized controlled trial to examine the effectiveness of an intervention that aims to reduce victimization in patients with dual diagnosis. If the intervention is effective it can be implemented in mental health care and contribute to the safety and well-being of patients.
Dutch Trial Register (NTR): 4472, date of registration: 24-03-2014.
与社区中的其他人相比，精神病患者更有可能成为犯罪的受害者。患有精神疾病和物质使用障碍合并症的双重诊断患者尤其容易受到伤害。受害与药物滥用、更严重的症状以及无家可归有关。非常需要采取干预措施来减少这一人群的受害情况。我们开发了“自我明智、他人明智、街头明智”（SOS）培训，以减少双重诊断患者的受害情况。
方法/设计：本研究是一项随机对照试验，采用平行组设计来确定在常规护理基础上增加SOS培训的有效性。双重诊断患者（N = 250）将使用计算机生成的分层区组随机化方法，被分配到常规护理加SOS培训组（N = 125）或仅接受常规护理组（N = 125）。为了比较有效性，将在基线以及随访2个月、8个月和14个月时对参与者进行访谈。主要结局指标是治疗反应（是/否），定义为在随访14个月时没有受到伤害，或者与基线评估相比，在随访14个月时受害事件至少减少50%。使用“安全监测器”来衡量受害情况，这是荷兰统计局用于在荷兰大规模测量受害情况的一种适当的自我报告工具。结局评估者对治疗分配情况不知情。将在随机对照试验的同时进行一项经济评估，并将从社会角度进行。
本研究是第一项随机对照试验，旨在检验旨在减少双重诊断患者受害情况的干预措施的有效性。如果该干预措施有效，它可以在精神卫生保健中实施，并有助于患者的安全和福祉。
荷兰试验注册库（NTR）：4472，注册日期：2014年3月24日。
