Slamanig Rudolf, Reisegger Andreas, Winkler Hildegard, de Girolamo Giovanni, Carrà Giuseppe, Crocamo Cristina, Fangerau Heiner, Markiewicz Inga, Heitzman Janusz, Salize Hans Joachim, Picchioni Marco, Wancata Johannes
Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Front Psychiatry. 2021 May 10;12:618860. doi: 10.3389/fpsyt.2021.618860. eCollection 2021.
The purpose of this systematic review is to systematically investigate which non-pharmacological interventions are effective in reducing violence risk among patients with schizophrenia spectrum disorders (SSD) in forensic settings. Six electronic data bases were searched. Two researchers independently screened 6,003 abstracts resulting in 143 potential papers. These were analyzed in detail by two independent researchers yielding 10 articles that could be used. Of the 10 articles, four were non-randomized controlled trials, three were pre-post studies without controls, and one was observational. Only two studies applied a randomized controlled trial design. Cognitive behavioral treatment programs were investigated in three studies. A broad range of other interventions were studied. Often outcome measures were specific to each study and sample sizes were small. Frequently, important methodological information was missing from the papers. It was not possible to carry out a meta-analysis due to the heterogeneity of the study designs and outcome measures. Because of methodological limitations it is difficult to draw firm conclusions about the effectiveness of non-pharmacological interventions to reduce the risk of violence in patents with SSD in forensic psychiatry settings. Studies applying better methods in terms of study design, sample sizes and outcome measures are urgently needed.
本系统评价的目的是系统地调查哪些非药物干预措施对降低法医环境中精神分裂症谱系障碍（SSD）患者的暴力风险有效。检索了六个电子数据库。两名研究人员独立筛选了6003篇摘要，得到143篇潜在论文。两名独立研究人员对这些论文进行了详细分析，最终得到10篇可用文章。在这10篇文章中，4篇为非随机对照试验，3篇为无对照的前后对照研究，1篇为观察性研究。只有两项研究采用了随机对照试验设计。三项研究对认知行为治疗方案进行了调查。还研究了一系列其他干预措施。通常，结果测量方法因研究而异，样本量较小。论文中经常缺少重要的方法学信息。由于研究设计和结果测量方法的异质性，无法进行荟萃分析。由于方法学上的局限性，很难就非药物干预措施在法医精神病学环境中降低SSD患者暴力风险的有效性得出确凿结论。迫切需要在研究设计、样本量和结果测量方法方面采用更好方法的研究。
