Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, LondonSE5 8AF, UK.
South London & Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, KentBR3 3BX, UK.
Psychol Med. 2021 Apr;51(5):707-715. doi: 10.1017/S0033291721000404. Epub 2021 Apr 16.
Evidence supports the use of group therapy for symptom reduction and improving functioning in people with psychosis. However, research guidelines highlight the importance of establishing the feasibility of interventions. Adherence is an important indicator of feasibility and an essential step in supporting the development of the evidence base for group interventions. This review aims to estimate adherence, and possible barriers and facilitators, to psychotherapeutic groups in people with psychosis.
Embase, Ovid MEDLINE and PsycINFO databases were searched for cross-referencing terms related to group therapy and psychosis. Studies were assessed against inclusion criteria and methodological quality was evaluated. Data wasextracted from each paper including the average session attendance, demographic, clinical, study and therapy-related characteristics and the impact of these on adherence levels evaluated.
Fifty-nine original research papers were included, reporting on 52 independent studies which consisted of 66 therapy groups comprised of 2109 participants. Average adherence was 76.4% (s.d. = 17.4). Adherence was improved by receiving incentives and was higher in participants of older age. Study sample size was inversely associated with adherence levels. Study quality was variable with approximately 61.5% found to be at risk of bias. The results support the feasibility of group therapy and suggest that adherence in people with psychosis is not dissimilar to those for people experiencing common mental health difficulties. These findings, alongside efficacy evidence, support the use of group interventions in people with psychosis but also highlight the need for further high-quality research on the efficacy for these approaches.
有证据表明，团体治疗可减少精神病患者的症状并改善其功能。然而，研究指南强调了确定干预措施可行性的重要性。依从性是可行性的一个重要指标，也是支持团体干预证据基础发展的重要步骤。本综述旨在评估精神病患者接受心理治疗团体的依从性，以及可能存在的障碍和促进因素。
通过交叉引用与团体治疗和精神病相关的术语，在 Embase、Ovid MEDLINE 和 PsycINFO 数据库中进行检索。根据纳入标准评估研究，并评估方法学质量。从每篇论文中提取数据，包括平均疗程出席率、人口统计学、临床、研究和治疗相关特征，以及这些特征对依从性水平的影响。
共纳入 59 篇原始研究论文，报告了 52 项独立研究，其中包括 66 个治疗组，共 2109 名参与者。平均依从率为 76.4%（标准差=17.4）。接受激励可以提高依从性，年龄较大的参与者依从性更高。研究样本量与依从性水平呈负相关。研究质量参差不齐，约有 61.5%的研究存在偏倚风险。结果支持团体治疗的可行性，并表明精神病患者的依从性与普通心理健康障碍患者相似。这些发现，加上疗效证据，支持在精神病患者中使用团体干预措施，但也强调需要进一步开展针对这些方法疗效的高质量研究。
