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多中心、随机、对照试验:一种针对首发精神病的联合临床治疗方法。

A Multicentre, Randomised, Controlled Trial of a Combined Clinical Treatment for First-Episode Psychosis.

机构信息

Centre for Biomedical Research in the Mental Health Network (CIBERSAM), 28029 Madrid, Spain.

Bioaraba Research Institute, Department of Psychiatry, Araba University Hospital, 01004 Vitoria, Spain.

出版信息

Int J Environ Res Public Health. 2021 Jul 6;18(14):7239. doi: 10.3390/ijerph18147239.

Abstract

INTRODUCTION

There is evidence that early intervention contributes to improving the prognosis and course of first-episode psychosis (FEP). However, further randomised treatment clinical trials are needed.

OBJECTIVES

The aim of this study was to compare the efficacy of a combined clinical treatment involving Cognitive Behavioural Therapy (CBT) as an adjunctive to treatment-as-usual (TAU) (CBT+TAU) versus TAU alone for FEP.

PATIENTS AND METHODS

In this multicentre, single-blind, randomised controlled trial, 177 participants were randomly allocated to either CBT+TAU or TAU. The primary outcome was post-treatment patient functioning.

RESULTS

The CBT+TAU group showed a greater improvement in functioning, which was measured using the Global Assessment Functioning (GAF) and Functioning Assessment Short Test (FAST), compared to the TAU group post-treatment. The CBT+TAU participants exhibited a greater decline in depressive, negative, and general psychotic symptoms; a better awareness of the disease and treatment adherence; and a greater increase in brain-derived neurotrophic factor levels than TAU participants.

CONCLUSIONS

Early intervention based on a combined clinical treatment involving CBT as an adjunctive to standard treatment may improve clinical and functional outcomes in FEP.

摘要

简介

有证据表明,早期干预有助于改善首发精神病(FEP)的预后和病程。然而,仍需要进一步的随机治疗临床试验。

目的

本研究旨在比较联合临床治疗(包括认知行为疗法[CBT]作为辅助治疗)与常规治疗(TAU)单独治疗 FEP 的疗效。

患者和方法

在这项多中心、单盲、随机对照试验中,177 名参与者被随机分配到 CBT+TAU 组或 TAU 组。主要结局是治疗后患者的功能。

结果

与 TAU 组相比,CBT+TAU 组在治疗后在功能方面表现出更大的改善,这是通过全球功能评估(GAF)和功能评估简短测试(FAST)来衡量的。CBT+TAU 组的抑郁、阴性和一般精神病症状下降更大,对疾病的认识和治疗依从性更好,脑源性神经营养因子水平升高更多。

结论

基于 CBT 联合临床治疗的早期干预可能会改善 FEP 的临床和功能结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bad3/8304114/7b78b01e10f1/ijerph-18-07239-g001.jpg

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