Klingberg S, Hesse K
Universitätsklinik für Psychiatrie und Psychotherapie, Calwer Str. 14, 72076, Tübingen, Deutschland.
Nervenarzt. 2018 Mar;89(3):276-282. doi: 10.1007/s00115-017-0474-0.
The major objective of this paper is to discuss the available evidence on the question as to which patients benefit most from psychotherapy in psychotic disorders and the question of which kind of psychotherapy. From a methodological perspective, this task can be seen as the question of moderators of treatment success. To answer this question, the status of efficacy research on psychotherapeutic interventions in schizophrenia is summarized in a first step. Secondly, studies comparing different active psychotherapeutic approaches are discussed. There are no studies available on routine psychotherapeutic care. However, there appears to be a rationale for recommending a combination of cognitive behavioural therapy (CBT) and family therapy. If patients prefer other approaches or if the treatment model does not suit the patient, other approaches should be offered. There is evidence for CBT that insight into psychosis, female gender, a higher level of education, and age >21 are indicators of a better course in CBT. Overall, the options for differential indications are highly limited and considerably more research is required.
本文的主要目的是讨论关于哪些精神病患者从心理治疗中获益最大以及哪种心理治疗方法这两个问题的现有证据。从方法论的角度来看，这项任务可被视为治疗成功的调节因素问题。为回答这个问题，第一步先总结精神分裂症心理治疗干预的疗效研究现状。其次，讨论比较不同积极心理治疗方法的研究。目前尚无关于常规心理治疗护理的研究。然而，推荐认知行为疗法（CBT）和家庭疗法相结合似乎有其合理性。如果患者倾向于其他方法，或者治疗模式不适合该患者，则应提供其他方法。有证据表明，对于CBT而言，对精神病的洞察力、女性性别、较高的教育水平以及年龄>21岁是CBT中病程较好的指标。总体而言，差异适应症的选择非常有限，需要进行更多的研究。
