Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark.
Mental Health Department Esbjerg, University Clinic, Region of Southern Denmark, Esbjerg N, Denmark.
J Psychiatr Ment Health Nurs. 2021 Aug;28(4):549-577. doi: 10.1111/jpm.12716. Epub 2020 Dec 28.
WHAT IS ALREADY KNOWN ON THE SUBJECT?: Understanding the need for psychoeducation and management strategies in relapse prevention, for individuals with schizophrenia or bipolar disorder. Interventions for individuals with severe mental illness, especially schizophrenia, often requires support from family or social network to successfully improve mental stability in the life of the mentally ill. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: To our knowledge, no previous review has provided an overview of state of the art intervention elements currently used in ambulant mental health care interventions and how these elements are combined in interventions tailored to individuals with schizophrenia or bipolar disorder. Moreover, this systematic review indicates the effect of the different intervention elements. This review reveals an apparent gab in knowledge regarding patient perceptions of and need for individualized relapse prevention interventions. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The review is a relevant tool for stakeholders and practitioners in community mental health service when planning future interventions. Considering the specific needs for intervention complexity of the target group is likely to improve not only treatment outcome, but also patient satisfaction and treatment adherence. ABSTRACT: Introduction In recent years, there has been a development in ambulant mental health care towards a more preventive approach, resulting in relapse prevention interventions. Interventions may be patient tailored, to a greater or lesser extent, in relation to the treatment elements included. Aim To create an overview of non-pharmacological intervention elements described in relapse prevention interventions for patients with schizophrenia or bipolar disorder based on a systematic review. Method Six scientific databases were systematically searched. The search strategy, identification and selection of literature complied with the PRISMA statement. Results Of 7.429 studies screened, 25 were included for analysis. Six treatment elements were identified: Pharmacological treatment, personalized action plan, patient education, patient skills, treatment adherence and family involvement. Discussion The varying degree of complexity of the interventions indicates that patients with bipolar disorder and schizophrenia have, respectively, different treatment needs. Patients with schizophrenia seem to benefit more from interventions that include support from social network or family than patients with bipolar disorder. More qualitative studies clarifying the patient's perspective on tailored relapse prevention are indicated. Implications for practice Optimally tailoring relapse prevention for patients with schizophrenia and bipolar disorder will improve treatment outcome, and probably also treatment satisfaction and adherence.
理解精神分裂症或双相情感障碍患者的心理教育和管理策略预防复发的必要性。针对严重精神疾病患者的干预措施，尤其是精神分裂症患者，通常需要家庭或社交网络的支持，以成功改善精神病患者的生活稳定性。本文新增信息：据我们所知，以前没有综述概述目前在门诊精神卫生保健干预中使用的最新干预要素，以及这些要素如何结合到针对精神分裂症或双相情感障碍患者的干预措施中。此外，本系统综述还指出了不同干预要素的效果。该综述揭示了一个明显的知识空白，即患者对个体化复发预防干预的看法和需求。这对实践有何影响：该综述是社区精神卫生服务利益相关者和从业人员在规划未来干预措施时的有用工具。考虑到目标群体的干预复杂性的具体需求，不仅可能提高治疗效果，还可能提高患者满意度和治疗依从性。摘要：引言近年来，门诊精神卫生保健朝着更具预防性的方法发展，从而产生了预防复发的干预措施。干预措施可以根据包括的治疗要素在更大或更小程度上针对患者进行定制。目的根据系统综述，创建精神分裂症或双相情感障碍患者预防复发干预措施中描述的非药物干预要素概述。方法系统检索了 6 个科学数据库。搜索策略、文献的识别和选择符合 PRISMA 声明。结果从筛选的 7429 项研究中，有 25 项被纳入分析。确定了 6 个治疗要素：药物治疗、个性化行动计划、患者教育、患者技能、治疗依从性和家庭参与。讨论干预措施的复杂程度不同表明，双相情感障碍和精神分裂症患者的治疗需求分别不同。与双相情感障碍患者相比，精神分裂症患者似乎从社交网络或家庭的支持中获益更多。需要更多的定性研究来阐明患者对个体化复发预防的看法。对实践的影响为精神分裂症和双相情感障碍患者量身定制预防复发的措施将改善治疗效果，而且可能还会提高治疗满意度和依从性。
