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[成瘾性障碍的循证心理治疗]

[Evidence-based psychotherapy of addictive disorders].

作者信息

Block I, Loeber S

机构信息

Lehrstuhl für Klinische Psychologie und Psychotherapie, Universität Bamberg, Markusplatz 3, 96047, Bamberg, Deutschland.

出版信息

Nervenarzt. 2018 Mar;89(3):283-289. doi: 10.1007/s00115-018-0483-7.

Abstract

BACKGROUND

Addictive disorders form the group of the most common mental disorders. A wide range of psychotherapeutic treatment interventions exists; however, the proportion of patients receiving evidence-based interventions or psychotherapeutic treatment in outpatient care is very low.

OBJECTIVE

The aim of the present review was a systematic reassessment of the empirical evidence for the efficacy of the different forms of psychotherapeutic treatment, identification of new effective interventions and derivation of recommendations for treatment practitioners.

MATERIAL AND METHODS

A comprehensive literature search in a multistage method in the relevant national and international data banks was conducted. Subsequent analysis of topical guidelines, systematic reviews and original studies about addictions and therapy was performed.

RESULTS

A total of 3 topical national guidelines, 2 reviews and 16 original studies could be identified. In particular, cognitive behavioral therapy, behavioral interventions and motivational interventions could be identified as evidence-based interventions for the treatment of addictive disorders. Hypnotherapy can be recommended alternatively for patients dependent on tobacco. Also interesting for practitioners could be new treatment methods, such as neurocognitive training and mindfulness-based interventions.

CONCLUSION

At present, although of high quality, results from existing studies are sometimes inconsistent or are numerically insufficient with respect to special treatment options. Future studies are warranted with respect to different substance use disorders and further patient groups.

摘要

背景

成瘾性障碍是最常见的精神障碍类型。存在多种心理治疗干预措施;然而,在门诊护理中接受循证干预或心理治疗的患者比例非常低。

目的

本综述的目的是对不同形式心理治疗疗效的实证证据进行系统重新评估,确定新的有效干预措施,并为治疗从业者得出建议。

材料与方法

采用多阶段方法在相关国家和国际数据库中进行全面文献检索。随后对有关成瘾和治疗的专题指南、系统评价和原始研究进行分析。

结果

共识别出3项专题国家指南、2篇综述和16项原始研究。特别是,认知行为疗法、行为干预和动机干预可被确定为治疗成瘾性障碍的循证干预措施。对于烟草依赖患者,可推荐替代使用催眠疗法。对从业者来说,新的治疗方法,如神经认知训练和基于正念的干预措施也可能很有意义。

结论

目前,尽管现有研究质量很高,但有时结果不一致,或者在特殊治疗选择方面数量不足。对于不同的物质使用障碍和更多患者群体,有必要开展进一步的研究。

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