Ramírez Alexandra, Palacio Juan David, Vargas Cristian, Díaz-Zuluaga Ana María, Duica Kelly, Agudelo Berruecos Yuli, Ospina Sigifredo, López-Jaramillo Carlos
Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Grupo de Epidemiología Hospitalaria, Hospital Universitario de San Vicente Fundación, Medellín, Colombia.
Rev Colomb Psiquiatr. 2017 Jan-Mar;46(1):2-11. doi: 10.1016/j.rcp.2016.02.004. Epub 2016 Apr 13.
Bipolar disorder and schizophrenia are causes of major suffering in patients. Nevertheless, they also affect family and caregiver functioning. This is important because the participation and involvement of families and caregivers is essential to achieve an optimal treatment.
To describe the level of expressed emotions, burden, and family functioning of bipolar and schizophrenic patients and, to evaluate the efficacy of the multimodal intervention (MI) versus traditional intervention (TI) in family functioning and its perception by patients and caregivers.
A prospective, longitudinal, therapeutic-comparative study was conducted with 302 patients (104 schizophrenic and 198 bipolar patients) who were randomly assigned to a MI or TI groups of a multimodal intervention program PRISMA. MI group received care from psychiatry, general medicine, neuropsychology, family therapy, and occupational therapy. TI group received care from psychiatry and general medicine. Hamilton, Young and SANS, SAPS scales were applied to bipolar and schizophrenic patients, respectively. The EEAG, FEICS, FACES III and ECF were also applied at the initial and final time.
There were statistically significant differences in socio- demographic and clinical variables in schizophrenia vs bipolar group: 83% vs 32.2% were male, 37 vs 43 mean age, 96% vs 59% were single, 50% vs 20% unemployed, and 20% vs 40% had college studies. In addition, 2 vs 2.5 numbers of hospitalisations, 18 vs 16 mean age of substance abuse onset and, 55 vs 80 points in EEAG. There were no statistically significant differences in family scales after conducting a multivariate analysis on thr initial and final time in both groups.
This study did not show changes in variables of burden and family functioning between bipolar and schizophrenic groups that were under TI vs MI.
双相情感障碍和精神分裂症给患者带来巨大痛苦。然而，它们也会影响家庭及照料者的功能。这一点很重要，因为家庭和照料者的参与对于实现最佳治疗至关重要。
描述双相情感障碍和精神分裂症患者的情感表达水平、负担及家庭功能，并评估多模式干预（MI）与传统干预（TI）在家庭功能方面的疗效以及患者和照料者对其的认知。
对302名患者（104名精神分裂症患者和198名双相情感障碍患者）进行了一项前瞻性、纵向、治疗对比研究，这些患者被随机分配到多模式干预项目PRISMA的MI组或TI组。MI组接受来自精神病学、普通医学、神经心理学、家庭治疗和职业治疗的护理。TI组接受来自精神病学和普通医学的护理。分别对双相情感障碍和精神分裂症患者应用汉密尔顿、杨氏及SANS、SAPS量表。在初始和最终阶段还应用了EEAG、FEICS、FACES III和ECF。
精神分裂症组与双相情感障碍组在社会人口统计学和临床变量方面存在统计学显著差异：男性比例分别为83%和32.2%，平均年龄分别为37岁和43岁，单身比例分别为96%和59%，失业比例分别为50%和20%，接受大学教育比例分别为20%和40%。此外，住院次数分别为2次和2.5次，物质滥用开始的平均年龄分别为18岁和16岁，EEAG得分分别为55分和80分。对两组初始和最终阶段进行多变量分析后，家庭量表方面无统计学显著差异。
本研究未显示在TI与MI模式下，双相情感障碍组和精神分裂症组在负担和家庭功能变量上有变化。
