疾病管理和康复：丹麦社区心理健康中心的一项随机对照试验的一年随访：对临床和个人康复的长期影响。
Illness management and recovery: one-year follow-up of a randomized controlled trial in Danish community mental health centers: long-term effects on clinical and personal recovery.
机构信息
Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
Region Zealand, University Hospital Roskilde, Roskilde, Denmark.
出版信息
BMC Psychiatry. 2019 Feb 11;19(1):65. doi: 10.1186/s12888-019-2048-0.
BACKGROUND
Illness Management and Recovery (IMR) is a curriculum-based rehabilitation program for people with severe mental illness with the short-term aim of improving illness self-management and the long-term aim of helping people achieve clinical and personal recovery.
METHOD
Participants with schizophrenia or bipolar disorders were recruited from three community mental health centers in the Capital Region of Denmark and randomized to receive group-based IMR and treatment as usual or only the usual intervention. All outcomes were assessed at baseline, postintervention, and the one-year follow-up. Long-term outcomes were categorized according to clinical recovery (i.e., symptoms, global functioning, and hospitalization) and personal recovery (i.e., hope and personal agency). Generalized linear mixed model regression analyses were used in the intent-to-treat analysis.
RESULTS
A total of 198 participants were included. No significant differences were found between the IMR and control groups in the Global Assessment of Functioning one year after the intervention, nor were there significant differences in symptoms, number of hospital admissions, emergency room visits, or outpatient treatment.
CONCLUSION
The present IMR trial showed no significant effect on clinical and personal recovery at the one-year follow-up. Together with the results of other IMR studies, the present study indicates that the effect of IMR on symptom severity is unclear, which raises questions regarding the impact of IMR on functioning. Additionally, IMR did not affect personal recovery. Although more research is needed, the results indicate that the development of other interventions should be considered to help people with severe mental illness achieve a better level of functioning and personal recovery.
TRIAL REGISTRATION
Trial registered at http://www.clinicaltrials.gov ( NCT01361698 ).
背景
疾病管理和康复（IMR）是一种针对严重精神疾病患者的基于课程的康复计划，短期目标是改善疾病自我管理，长期目标是帮助人们实现临床和个人康复。
方法
参与者为丹麦首都地区的三家社区心理健康中心的精神分裂症或双相情感障碍患者，他们被随机分为接受基于小组的 IMR 治疗和常规治疗，或仅接受常规干预的两组。所有结果均在基线、干预后和一年随访时进行评估。长期结果根据临床康复（即症状、总体功能和住院）和个人康复（即希望和个人能动性）进行分类。意向治疗分析采用广义线性混合模型回归分析。
结果
共纳入 198 名参与者。干预一年后，IMR 组和对照组在总体功能评估方面无显著差异，症状、住院次数、急诊就诊次数或门诊治疗也无显著差异。
结论
本 IMR 试验在一年随访时未显示对临床和个人康复有显著影响。结合其他 IMR 研究的结果，本研究表明 IMR 对症状严重程度的影响尚不清楚，这引发了对 IMR 对功能影响的质疑。此外，IMR 并未影响个人康复。尽管需要进一步研究，但结果表明，应考虑开发其他干预措施，以帮助严重精神疾病患者达到更好的功能和个人康复水平。
试验注册
试验在 http://www.clinicaltrials.gov 上注册（NCT01361698）。
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