Riffer Friedrich, Sprung Manuel, Streibl Lore, Kaiser Elmar
Psychosomatische Klinik Eggenburg, Psychosomatisches Zentrum Waldviertel (PSZW), Grafenberger Straße 2, 3730, Eggenburg, Österreich.
Rehabilitationsklinik Gars am Kamp, Psychosomatisches Zentrum Waldviertel (PSZW), Gars am Kamp, Österreich.
Neuropsychiatr. 2018 Mar;32(1):33-43. doi: 10.1007/s40211-017-0254-x. Epub 2017 Dec 13.
The specific effectiveness of psychiatric rehabilitation has been confirmed in numerous studies. Of particular interest is to what extend different results can be observed regarding the occupational status and type of mental illness of patients. Unemployment at the start of treatment is generally deemed to be a disadvantage for treatment outcome. Weaker treatment effects have also been reported for some types of mental illnesses, such as pain- und somatoform disorders.
Results from the evaluation of a sample of 2260 patients form the psychiatric rehabilitation clinic Gars am Kamp were analyzed, with regard to the occupational status and type of mental illness of patients. Changes in general symptom severity, quality of life and functioning were assessed.
Regarding the occupational status, overall unemployed patients suffered from higher degrees of global symptom severity and the lower levels of global quality of life compared to employed and retired patients. However, improvements in the course of rehabilitative treatment could be observed regardless of the occupational status of patients. Regarding the type of mental illness, overall patients with burnout (Z73.0) reported the lowest levels of global symptom severity and highest degree of global quality of life. In comparison patients with somatoform disorders (F45) showed the lowest degree of global quality of life. However, positive treatment effects regarding general symptom severity and health related quality of life could be observed regardless of the type of mental illness (diagnosis) of patients. In respect to the improvement of global functioning small differences in absolute treatment effects were detected depending on the type of diagnosis of patients. However, relative treatment effects in respect to global functioning were comparable for all types of diagnosis.
Improvements in the course of rehabilitative treatment regarding general symptom severity, quality of life and global functioning can be obtained independent of occupational status and type of mental illness of patients.
多项研究已证实精神康复的具体效果。特别值得关注的是，在患者的职业状况和精神疾病类型方面能观察到何种程度的不同结果。治疗开始时的失业状况通常被认为对治疗结果不利。对于某些类型的精神疾病，如疼痛和躯体形式障碍，也有报道称治疗效果较弱。
分析了来自加尔斯阿姆坎普精神康复诊所的2260名患者样本的评估结果，涉及患者的职业状况和精神疾病类型。评估了总体症状严重程度、生活质量和功能的变化。
在职业状况方面，与在职和退休患者相比，总体失业患者的全球症状严重程度更高，全球生活质量更低。然而，无论患者的职业状况如何，在康复治疗过程中都能观察到改善。在精神疾病类型方面，总体而言，倦怠患者（Z73.0）的全球症状严重程度最低，全球生活质量最高。相比之下，躯体形式障碍患者（F45）的全球生活质量最低。然而，无论患者的精神疾病类型（诊断）如何，在总体症状严重程度和与健康相关的生活质量方面都能观察到积极的治疗效果。在全球功能改善方面，根据患者的诊断类型，绝对治疗效果存在微小差异。然而，所有诊断类型在全球功能方面的相对治疗效果相当。
在康复治疗过程中，无论患者的职业状况和精神疾病类型如何，在总体症状严重程度、生活质量和全球功能方面都能取得改善。
