Calvo Paula, Fortuny Joan R, Guzmán Sergio, Macías Cristina, Bowen Jonathan, García María L, Orejas Olivia, Molins Ferran, Tvarijonaviciute Asta, Cerón José J, Bulbena Antoni, Fatjó Jaume
Chair Affinity Foundation Animals and Health, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de BarcelonaBellaterra, Spain; Hospital del Mar Medical Research InstituteBarcelona, Spain.
Centres Assistencials Emili Mira, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar Santa Coloma de Gramenet, Spain.
Front Psychol. 2016 May 6;7:631. doi: 10.3389/fpsyg.2016.00631. eCollection 2016.
Currently, one of the main objectives of human-animal interaction research is to demonstrate the benefits of animal assisted therapy (AAT) for specific profiles of patients or participants. The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6-month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre-program with post-program scores for the Positive and Negative Syndrome Scale (PANSS) and the EuroQoL-5 dimensions questionnaire (EuroQol-5D), pre-session with post-session salivary cortisol and alpha-amylase for the last four AAT sessions, and adherence rates between different elements of the program. We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty-two institutionalized patients with chronic schizophrenia completed the 6-month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning), a community program (intended to facilitate community reintegration) and a family program. Each member of the control group (n = 8) participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT-treatment group (n = 14) participated in twice-weekly 1-h sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT-treatment) showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT-treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT-treatment was significantly higher than overall adherence to the control group's functional rehabilitation activities. Cortisol level was significantly reduced after participating in an AAT session, which could indicate that interaction with the therapy dogs reduced stress. In conclusion, the results of this small-scale RCT suggest that AAT could be considered a useful adjunct to conventional psychosocial rehabilitation for people with schizophrenia.
目前,人-动物互动研究的主要目标之一是证明动物辅助疗法(AAT)对特定类型的患者或参与者有益。本研究的目的是评估一项AAT计划作为精神分裂症患者常规6个月心理社会康复计划辅助手段的效果。我们的假设是,将AAT纳入心理社会康复将对整个计划对症状和生活质量的影响产生积极贡献,并且AAT对患者来说将是一次积极的体验。为了验证这些假设,我们比较了计划前与计划后阳性和阴性症状量表(PANSS)以及欧洲生活质量五维度问卷(EuroQol-5D)的得分,比较了最后四次AAT疗程中每次疗程前与疗程后的唾液皮质醇和α-淀粉酶水平,以及该计划不同组成部分的依从率。我们在西班牙的一家精神科护理中心进行了一项随机对照研究。22名患有慢性精神分裂症的住院患者完成了为期6个月的康复计划,该计划包括个体心理治疗、团体治疗、功能计划(旨在改善日常功能)、社区计划(旨在促进社区重新融入)和家庭计划。对照组的每个成员(n = 8)参加了一系列作为功能计划一部分的治疗活动中的一项活动。作为该功能计划活动的替代,AAT治疗组(n = 14)参加了每周两次、每次1小时的AAT疗程。所有参与者每周接受的康复总时长相同。在计划结束时,两组(对照组和AAT治疗组)用PANSS测量的阳性和总体症状均有显著改善,但只有AAT治疗组在阴性症状方面有显著改善。AAT治疗的依从性显著高于对照组功能康复活动的总体依从性。参与AAT疗程后皮质醇水平显著降低,这可能表明与治疗犬的互动减轻了压力。总之,这项小规模随机对照试验的结果表明,AAT可被视为精神分裂症患者常规心理社会康复的有用辅助手段。