Hamilton Jane E, Srivastava Devika, Womack Danica, Brown Ashlie, Schulz Brian, Macakanja April, Walker April, Wu Mon-Ju, Williamson Mark, Cho Raymond Y
Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center Houston, 1941 East Road, Suite 1204, Houston, TX, 77054, USA.
Harris Center for Mental Health and IDD, Houston, TX, USA.
J Behav Health Serv Res. 2019 Jul;46(3):415-433. doi: 10.1007/s11414-018-9619-6.
Young adults experiencing first-episode psychosis have historically been difficult to retain in mental health treatment. Communities across the United States are implementing Coordinated Specialty Care to improve outcomes for individuals experiencing first-episode psychosis. This mixed-methods research study examined the relationship between program services and treatment retention, operationalized as the likelihood of remaining in the program for 9 months or more. In the adjusted analysis, male gender and participation in home-based cognitive behavioral therapy were associated with an increased likelihood of remaining in treatment. The key informant interview findings suggest the shared decision-making process and the breadth, flexibility, and focus on functional recovery of the home-based cognitive behavioral therapy intervention may have positively influenced treatment retention. These findings suggest the use of shared decision-making and improved access to home-based cognitive behavioral therapy for first-episode psychosis patients may improve outcomes for this vulnerable population.
从历史上看，首次发作精神病的年轻人很难坚持接受心理健康治疗。美国各地的社区正在实施协调专科护理，以改善首次发作精神病患者的治疗效果。这项混合方法研究考察了项目服务与治疗留存率之间的关系，治疗留存率定义为在项目中停留9个月或更长时间的可能性。在调整分析中，男性性别和参与居家认知行为疗法与治疗留存可能性增加有关。关键信息提供者访谈结果表明，共同决策过程以及居家认知行为疗法干预的广度、灵活性和对功能恢复的关注可能对治疗留存产生了积极影响。这些发现表明，对首次发作精神病患者采用共同决策并增加居家认知行为疗法的可及性，可能会改善这一弱势群体的治疗效果。
