个体安置与支持、就业以及个人和临床康复的系统评价

A Systematic Review of Individual Placement and Support, Employment, and Personal and Clinical Recovery.

机构信息

Research Unit of Mental Health and Department of Clinical Research, University of Southern Denmark, Odense, Denmark (Wallstroem); DEFACTUM, Central Denmark Region, and Department of Public Health, Aarhus University, Aarhus, Denmark (Pedersen); Copenhagen Research Center for Mental Health, Copenhagen (Christensen, Hellström, Bojesen, Eplov); Institute of Health and Medical Sciences, University of Copenhagen (Christensen); Research Unit of Mental Health, Aabenraa, Denmark, and Department of Regional Health Services, University of Southern Denmark, Odense, Denmark (Stenager); Population Health Research Institute, St. George's University of London, London (White); Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser); Department of Health Sciences, Lund University, Lund, Sweden (Bejerholm); University Medical Center Groningen, and University Center of Psychiatry, University of Groningen, Groningen, Netherlands (van Busschbach); Movisie and Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht (Michon).

出版信息

Psychiatr Serv. 2021 Sep 1;72(9):1040-1047. doi: 10.1176/appi.ps.202000070. Epub 2021 May 4.

DOI:10.1176/appi.ps.202000070

PMID:33940948

Abstract

OBJECTIVE

The objective of this review was to assess associations between Individual Placement and Support (IPS), employment, and personal and clinical recovery among persons with severe mental illness at 18-month follow-up.

METHODS

A systematic literature search identified randomized controlled trials (RCTs) comparing IPS with services as usual. Outcomes were self-esteem, empowerment, quality of life, symptoms of depression, negative or psychotic symptoms, anxiety, and level of functioning. A total of six RCTs reported data suitable for meta-analyses, and pooled original data from five studies were also analyzed.

RESULTS

Meta-analyses and analyses of pooled original data indicated that receipt of the IPS intervention alone did not improve any of the recovery outcomes. Participants who worked during the study period, whether or not they were IPS participants, experienced improved negative symptoms, compared with those who did not work (standardized mean difference [SMD]=-0.41, 95% confidence interval [CI]=-0.56, -0.26). For participants who worked, whether or not they were IPS participants, improvements were also found in level of functioning and quality of life (SMD=0.59, 95% CI=0.42, 0.77 and SMD=0.34, 95% CI=0.14, 0.54, respectively).

CONCLUSIONS

Employment was associated with improvements in negative symptoms, level of functioning, and quality of life.

摘要

目的

本综述旨在评估在 18 个月随访时，个体安置与支持（IPS）与就业以及严重精神疾病患者的个人和临床康复之间的关联。

方法

系统文献检索确定了比较 IPS 与常规服务的随机对照试验（RCT）。结果是自尊、赋权、生活质量、抑郁症状、阴性或精神病症状、焦虑和功能水平。共有六项 RCT 报告了适合荟萃分析的数据，还分析了五项研究的汇总原始数据。

结果

荟萃分析和汇总原始数据分析表明，单独接受 IPS 干预并不能改善任何康复结果。在研究期间工作的参与者，无论是否是 IPS 参与者，与未工作的参与者相比，负面症状得到改善（标准化均数差 [SMD]=-0.41，95%置信区间 [CI]=-0.56，-0.26）。对于工作的参与者，无论是否是 IPS 参与者，功能水平和生活质量也有所改善（SMD=0.59，95% CI=0.42，0.77 和 SMD=0.34，95% CI=0.14，0.54）。