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严重精神疾病的心理社会治疗:证据更新与推荐

Psychosocial therapies in severe mental illness: update on evidence and recommendations.

机构信息

Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig.

Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Hospital Am Urban, Berlin.

出版信息

Curr Opin Psychiatry. 2020 Jul;33(4):414-421. doi: 10.1097/YCO.0000000000000618.

Abstract

PURPOSE OF REVIEW

To provide an overview of the update of the evidence-based and consensus-based German S3 guideline on psychosocial therapies for severe mental illnesses (SMI), with particular attention to current developments and future research tasks.

RECENT FINDINGS

There has been a significant increase in studies on the effectiveness of psychosocial interventions in treatment of people with SMI. In the guideline a distinction is made between system-level interventions (e.g. multidisciplinary team-based psychiatric community care) and single-handed (nonteam-based) interventions (e.g. psychoeducation). Furthermore, principles of treatment (e.g. recovery-orientation) and self-help interventions (e.g. peer support) are addressed. The update of the guideline includes 33 recommendations and 12 statements. Compared with the first edition, there were upgrades in the recommendation of Supported Employment (A) and Supported Housing (A). Interventions such as peer support (B) and lifestyle interventions (A) were included for the first time. Developments are discussed in the context of most recent literature. Areas for further research are highlighted and fields for next updates such as antistigma interventions and supported parenting were identified.

SUMMARY

The present guideline offers an important opportunity to further improve health services for people with SMI. However, guideline implementation is challenging.

摘要

目的综述

提供基于循证和共识的德国 S3 指南对严重精神疾病(SMI)的心理社会治疗的更新概述,特别关注当前的发展和未来的研究任务。

最近的发现

关于心理社会干预对 SMI 患者治疗效果的研究显著增加。在指南中,区分了系统层面的干预措施(如多学科团队为基础的精神病社区护理)和单人干预措施(如心理教育)。此外,还涉及了治疗原则(如康复导向)和自助干预措施(如同伴支持)。指南的更新包括 33 条建议和 12 条陈述。与第一版相比,支持性就业(A)和支持性住房(A)的建议得到了升级。首次纳入了同伴支持(B)和生活方式干预(A)等干预措施。在讨论中考虑了最新文献中的发展。突出了进一步研究的领域,并确定了下一次更新的领域,如抗污名化干预和支持性育儿。

总结

本指南为进一步改善 SMI 患者的卫生服务提供了重要机会。然而,指南的实施具有挑战性。

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