Abbass Allan, Town Joel, Johansson Robert, Lahti Melissa, Kisely Steve
Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Psychology, Stockholm University, Sweden.
Psychodyn Psychiatry. 2019 Spring;47(1):99-112. doi: 10.1521/pdps.2019.47.1.99.
The aim of this study was to evaluate changes in long-term health care costs and symptom severity after adjunctive intensive short-term dynamic psychotherapy (ISTDP) individually tailored and administered to patients with bipolar disorder undergoing standard psychiatric care. Eleven therapists with different levels of expertise delivered an average of 4.6 one-hour sessions of ISTDP to 29 patients with bipolar disorders. Health care service costs were compiled for a one-year period prior to the start of ISTDP along with four one-year periods after termination. Two validated self-report scales, the Brief Symptom Inventory and the Inventory of Interpersonal Problems, were administered at intake and termination of ISTDP. Hospital cost reductions were significant for the one-year post-treatment period relative to baseline year, and all cost reductions were sustained for the follow-up period of four post-treatment years. Self-reported psychiatric symptoms and interpersonal problems were significantly reduced. These preliminary findings suggest that this brief adjunctive psychotherapy may be beneficial and cost-effective in select patients with bipolar disorders, and that gains may be sustained in long-term followup. Future research directions are discussed.
本研究的目的是评估为接受标准精神科护理的双相情感障碍患者量身定制并单独实施辅助强化短期动态心理治疗（ISTDP）后，长期医疗保健成本和症状严重程度的变化。11名具有不同专业水平的治疗师为29名双相情感障碍患者平均提供了4.6次为时一小时的ISTDP治疗。在ISTDP开始前的一年期间以及治疗结束后的四个一年期间，收集了医疗保健服务成本。在ISTDP治疗开始时和结束时，使用了两个经过验证的自我报告量表，即简明症状量表和人际问题量表。相对于基线年，治疗后一年期间的医院成本显著降低，并且在治疗后的四年随访期内，所有成本降低情况均持续存在。自我报告的精神症状和人际问题显著减少。这些初步研究结果表明，这种简短的辅助心理治疗可能对特定的双相情感障碍患者有益且具有成本效益，并且在长期随访中可能持续获益。文中还讨论了未来的研究方向。
