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精神分裂谱系障碍患者的临床康复与个人康复之间的关系:系统评价和荟萃分析。

The Relationship Between Clinical and Personal Recovery in Patients With Schizophrenia Spectrum Disorders: A Systematic Review and Meta-analysis.

机构信息

Arkin Institute for Mental Health, Amsterdam, The Netherlands.

Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Schizophr Bull. 2018 Apr 6;44(3):631-642. doi: 10.1093/schbul/sbx088.

Abstract

Patients describe experiencing personal recovery despite ongoing symptoms of psychosis. The aim of the current research was to perform a meta-analysis investigating the relationship between clinical and personal recovery in patients with schizophrenia spectrum disorders. A comprehensive OvidSP database search was performed to identify relevant studies. Correlation coefficients of the relationship between clinical and personal recovery were retrieved from primary studies. Meta-analyses were performed, calculating mean weighted effect sizes for the association between clinical and personal recovery, hope, and empowerment. Additionally, associations between positive, negative, affective symptoms, general functioning, and personal recovery were investigated. The results show that heterogeneity across studies was substantial. Random effect meta-analysis of the relationship between symptom severity and personal recovery revealed a mean weighted correlation coefficient of r = -.21 (95% CI = -0.27 to -0.14, P < .001). We found the following mean weighted effect size for positive symptoms r = -.20 (95% CI = -0.27 to -0.12, P < .001), negative symptoms r = -.24 (95% CI = -0.33 to -0.15, P < .001), affective symptoms r = -.34 (95% CI = -0.44 to -0.24, P < .001) and functioning r = .21 (95% CI = -0.09 to 0.32, P < .001). The results indicate a significant small to medium association between clinical and personal recovery. Psychotic symptoms show a smaller correlation than affective symptoms with personal recovery. These findings suggest that clinical and personal recovery should both be considered in treatment and outcome monitoring of patients with schizophrenia spectrum disorders.

摘要

患者描述了尽管存在持续的精神病症状,但仍经历了个人康复。当前研究的目的是进行荟萃分析,以调查精神分裂症谱系障碍患者的临床和个人康复之间的关系。通过全面的 OvidSP 数据库搜索,确定了相关研究。从主要研究中检索了临床和个人康复之间关系的相关系数。进行了荟萃分析,计算了临床和个人康复、希望和赋权之间关联的平均加权效应大小。此外,还研究了阳性、阴性、情感症状、一般功能与个人康复之间的关联。结果表明,研究之间的异质性很大。症状严重程度与个人康复之间关系的随机效应荟萃分析显示,平均加权相关系数 r = -.21(95%CI = -0.27 至 -0.14,P <.001)。我们发现阳性症状的平均加权效应大小 r = -.20(95%CI = -0.27 至 -0.12,P <.001),阴性症状 r = -.24(95%CI = -0.33 至 -0.15,P <.001),情感症状 r = -.34(95%CI = -0.44 至 -0.24,P <.001)和功能 r =.21(95%CI = -0.09 至 0.32,P <.001)。结果表明,临床和个人康复之间存在显著的小到中等关联。精神症状与个人康复的相关性比情感症状小。这些发现表明,在精神分裂症谱系障碍患者的治疗和结果监测中,应同时考虑临床和个人康复。

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