简要的多家庭心理教育对慢性重性抑郁症患者家属的效果：一项随机对照试验。
Brief multifamily Psychoeducation for family members of patients with chronic major depression: a randomized controlled trial.
机构信息
Department of Psychiatric and Mental Health Nursing, Nagoya City University School of Nursing, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan.
Department of Psychiatry, Japanese Red Cross Nagoya Daini Hospital, Myokencho 2-9, Syowa-ku, Nagoya, Japan.
出版信息
BMC Psychiatry. 2018 Jun 22;18(1):207. doi: 10.1186/s12888-018-1788-6.
BACKGROUND
Major depressive disorder (MDD) is a common and often chronic problem. Patients with chronic MDD often have negative impacts on the health of their families. Family psychoeducation is recognized as part of the optimal treatment for patients with psychotic disorder, and has been shown to reduce the rate of relapse in individuals with schizophrenia and to reduce the burden on their caregivers. Thus, we predict that family psychoeducation has the potential to reduce the burden on the caregivers of patients with chronic MDD. In the present study, we aimed to investigate the effects of brief multifamily psychoeducation (BMP) on the mental health status of family members of patients with chronic MDD.
METHODS
We conducted a clinical trial consisting of 49 chronic MDD patients and their families. Each family was randomly assigned to either the BMP intervention group or the control group. The intervention group received four BMP sessions, once every two weeks for eight weeks. The control group received one counseling session administered by a nurse. All patients received standard treatment administered by physicians. The primary outcome measurement was the Kessler Screening Scale for Psychological Distress (K6) score of family members at 16- weeks after the first BMP session. Secondary outcomes were depressive symptoms of both family members and patients at multiple time points, as well as family functioning as evaluated by the patients. Intention-to-treat analyses were conducted.
RESULTS
There was no statistically significant effect of BMP on K6 scores at 16- weeks (mean difference 1.17, 95% confidence interval: - 0.63 to 2.98, P = 0.19). Exploratory analyses revealed that BMP reduced depressive symptoms in family members at 8- weeks (difference = - 3.37, 95%CI -6.32 to - 0.43, P = 0.02) and improved family functioning at multiple time points (Role; 8 W, difference = - 0.13, 95%CI -0.26 to - 0.00, P = 0.04, Affective Responsiveness; 8 W, difference = - 0.24, 95%CI -0.43 to - 0.05, P = 0.01, 32 W, difference = - 0.22, 95%CI -0.41 to - 0.03, P = 0.02, Behavior Control; 16 W, difference = - 0.17, 95%CI -0.34 to - 0.00, P = 0.04).
CONCLUSIONS
Four BMP sessions did not significantly reduce the psychological distress of family members of patients with chronic MDD.
TRIAL REGISTRATION
Clinical Trials. gov NCT01734291 , retrospectively registered (Registration date: November 21, 2012).
背景
重度抑郁症（MDD）是一种常见且常为慢性的问题。患有慢性 MDD 的患者常常对其家庭的健康产生负面影响。家庭心理教育被认为是精神病患者最佳治疗方案的一部分，并且已被证明可降低精神分裂症患者的复发率，并减轻其照顾者的负担。因此，我们预计家庭心理教育有可能减轻慢性 MDD 患者照顾者的负担。在本研究中，我们旨在探讨简短多家庭心理教育（BMP）对慢性 MDD 患者家庭成员心理健康状况的影响。
方法
我们进行了一项临床试验，纳入了 49 名慢性 MDD 患者及其家属。每个家庭随机分为 BMP 干预组或对照组。干预组接受了四次 BMP 课程，每两周一次，共八周。对照组接受了由护士进行的一次咨询。所有患者均接受了医生的标准治疗。主要结局测量指标是首次 BMP 课程 16 周后家庭成员的 Kessler 心理困扰筛查量表（K6）评分。次要结局包括多个时间点家庭成员和患者的抑郁症状以及患者评估的家庭功能。采用意向治疗分析。
结果
BMP 对 16 周时的 K6 评分没有统计学上的显著影响（平均差值 1.17，95%置信区间：-0.63 至 2.98，P=0.19）。探索性分析显示，BMP 可在 8 周时降低家庭成员的抑郁症状（差值=-3.37，95%CI -6.32 至 -0.43，P=0.02），并在多个时间点改善家庭功能（角色；8 周，差值=-0.13，95%CI -0.26 至 -0.00，P=0.04，情感反应性；8 周，差值=-0.24，95%CI -0.43 至 -0.05，P=0.01，32 周，差值=-0.22，95%CI -0.41 至 -0.03，P=0.02，行为控制；16 周，差值=-0.17，95%CI -0.34 至 -0.00，P=0.04）。
结论
四次 BMP 课程并未显著减轻慢性 MDD 患者家庭成员的心理困扰。
试验注册
ClinicalTrials.gov 注册号 NCT01734291，回顾性注册（注册日期：2012 年 11 月 21 日）。
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