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基于证据的精神分裂症患者综合干预:现实康复环境中可行性和有效性的初步研究。

Evidence-Based Integrated Intervention in Patients with Schizophrenia: A Pilot Study of Feasibility and Effectiveness in a Real-World Rehabilitation Setting.

机构信息

Department of Clinical and Experimental Sciences, University of Brescia, 25133 Brescia, Italy.

Department of Mental Health and Addiction Services, ASST Spedali Civili, 25133 Brescia, Italy.

出版信息

Int J Environ Res Public Health. 2020 May 12;17(10):3352. doi: 10.3390/ijerph17103352.

Abstract

Impairment in real-world functioning remains one of the most problematic challenges that people with schizophrenia have to face. Various psychosocial interventions have proven to be effective in promoting recovery and improving functioning in schizophrenia; however, their implementation and their effectiveness in routine rehabilitation practice are still objects of study. The present pilot study aimed to assess the feasibility and effectiveness on clinical and real-world outcomes of an integrated treatment protocol composed of stable pharmacological treatment, computer-assisted cognitive remediation and social skills training provided in a rehabilitation center. Predictors of functional improvement were also assessed. Seventy-two patients diagnosed with schizophrenia participated in the study. A significant ( < 0.001) improvement in positive, negative and total symptoms, as well as in global clinical severity and real-world functioning outcomes was observed, with a large effect size in positive and total symptoms, global clinical severity and real-world functioning, and a moderate effect size on negative symptoms. Improvement in total symptoms ( < 0.001) and in global clinical severity ( = 0.007) emerged as individual predictors of functional improvement. These findings, although preliminary, suggest that an integrated, evidence-based treatment program is feasible and effective in a real-world rehabilitation context, and that similar interventions should be further implemented in everyday clinical practice.

摘要

现实世界功能障碍仍然是精神分裂症患者面临的最具挑战性的问题之一。各种心理社会干预措施已被证明在促进精神分裂症患者康复和改善功能方面是有效的;然而,它们在常规康复实践中的实施及其有效性仍然是研究的对象。本初步研究旨在评估在康复中心提供的稳定药物治疗、计算机辅助认知矫正和社交技能训练综合治疗方案对临床和现实世界结果的可行性和有效性。还评估了功能改善的预测因素。72 名被诊断为精神分裂症的患者参加了这项研究。阳性、阴性和总症状以及总体临床严重程度和现实世界功能结果均有显著改善(<0.001),阳性和总症状、总体临床严重程度和现实世界功能的效应量较大,阴性症状的效应量中等。总症状(<0.001)和总体临床严重程度(=0.007)的改善是功能改善的个体预测因素。这些发现虽然初步的,但表明综合、基于证据的治疗方案在现实世界的康复环境中是可行和有效的,并且类似的干预措施应该在日常临床实践中进一步实施。

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