Centre Hospitalier Saint-Jean-de-Dieu.
Centre Référent en Réhabilitation Psychosociale et en Remédiation Cognitive (CL3R), Centre Hospitalier Le Vinatier.
J Nerv Ment Dis. 2020 Apr;208(4):329-339. doi: 10.1097/NMD.0000000000001125.
Therapeutic alliance determines medical treatment adherence, the success of psychotherapy, and the effectiveness of care. This systematic review aims at better understanding its determinants. The electronic databases Pubmed, Cochrane Library, and Web of Science were searched, using combinations of terms relating to psychosis and therapeutic alliance. Studies were selected and data were extracted using a PRISMA statement. Forty-one studies were selected, including 20 cross-sectional studies, 10 cohort studies, five randomized controlled trials, four literature reviews, and two retrospective studies. The quality of therapeutic alliance correlates with clinical symptoms, insight, social and family support, the therapist's qualities, the availability of shared therapeutic decision making, and the types of hospitalization. Although current evidence needs to be completed with further studies, it is already clear that group and family psychoeducation, cognitive remediation, community-based psychiatric services, and shared therapeutic decision making are essential approaches in the management of patients with psychosis.
治疗联盟决定了医疗依从性、心理治疗的成功和护理的效果。本系统评价旨在更好地了解其决定因素。使用与精神病和治疗联盟相关的术语组合，检索了电子数据库 Pubmed、Cochrane Library 和 Web of Science。使用 PRISMA 声明选择研究并提取数据。共选择了 41 项研究，包括 20 项横断面研究、10 项队列研究、5 项随机对照试验、4 项文献综述和 2 项回顾性研究。治疗联盟的质量与临床症状、洞察力、社会和家庭支持、治疗师的素质、共享治疗决策的可用性以及住院类型有关。尽管目前的证据需要进一步研究来完善，但已经很清楚的是，团体和家庭心理教育、认知矫正、基于社区的精神科服务和共享治疗决策是精神疾病患者管理的重要方法。
