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多模式干预项目-PRISMA中双相情感障碍和精神分裂症患者的评估与社会职业干预

Evaluation and Socio-occupational Intervention in Bipolar and Schizophrenic Patients within a Multimodal Intervention Program- PRISMA.

作者信息

Díaz Zuluaga Ana M, Duica Kelly, Ruiz Galeano Carlos, Vargas Cristian, Agudelo Berruecos Yuli, Ospina Sigifredo, López-Jaramillo Carlos

机构信息

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.

出版信息

Rev Colomb Psiquiatr (Engl Ed). 2018 Jan-Mar;47(1):4-12. doi: 10.1016/j.rcp.2017.01.006. Epub 2017 Feb 21.

Abstract

BACKGROUND

Functional improvement in bipolar and schizophrenic patients is one of the main aims of treatment. Nevertheless, there is no evidence about the effect of socio-occupational intervention within a multimodal intervention (MI) programme.

OBJECTIVE

To describe the socio-occupational profile and to evaluate the functional effect of a MI in bipolar I and schizophrenic patients.

METHODS

A prospective, longitudinal, therapeutic-comparative study was performed including 302 subjects (104 schizophrenic and 198 Bipolar Disorder I [BDI] patients), who were randomised into two groups, multimodal (psychiatry, psychology, medicine, occupational therapy, neuropsychology, and family therapy), or traditional intervention (psychiatry and medicine only). Several scales were applied to assess assertiveness, free time management, social abilities, general anxiety, self-care and performance in home, work and community tasks.

RESULTS

After performing the longitudinal analysis, it was shown that the multimodal intervention was more effective than traditional intervention in general anxiety scores (P=.026) and development in home tasks (P=.03) in schizophrenic patients. No statistical differences were found in bipolar patients. The other variables showed improvement, however, their effect was similar in both intervention groups.

CONCLUSIONS

Our study identified functional improvement in home tasks in schizophrenic patients after receiving multimodal intervention. Other variables also showed improvement for both interventions groups. Future studies, applying longer rehabilitation programs and other ecological strategies should be performed to identify the most effective interventions.

摘要

背景

双相情感障碍和精神分裂症患者的功能改善是治疗的主要目标之一。然而,尚无证据表明社会职业干预在多模式干预(MI)项目中的效果。

目的

描述双相I型障碍和精神分裂症患者的社会职业概况,并评估多模式干预对其功能的影响。

方法

进行了一项前瞻性、纵向、治疗对比研究,纳入302名受试者(104名精神分裂症患者和198名双相I型障碍[BDI]患者),将他们随机分为两组,即多模式干预组(包括精神病学、心理学、医学、职业治疗、神经心理学和家庭治疗)和传统干预组(仅包括精神病学和医学)。应用多个量表评估自信、休闲时间管理、社交能力、一般焦虑、自我护理以及在家务、工作和社区任务中的表现。

结果

经过纵向分析,结果显示多模式干预在精神分裂症患者的一般焦虑评分(P = 0.026)和家务进展(P = 0.03)方面比传统干预更有效。双相情感障碍患者未发现统计学差异。其他变量也有所改善,然而,两组干预措施的效果相似。

结论

我们的研究发现精神分裂症患者接受多模式干预后在家务方面功能得到改善。其他变量在两组干预中也都有所改善。未来应开展应用更长康复项目和其他生态策略的研究,以确定最有效的干预措施。

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