Stevović Lidija Injac, Repišti Selman, Radojičić Tamara, Sartorius Norman, Tomori Sonila, Kulenović Alma Džubur, Popova Ana, Kuzman Martina Rojnić, Vlachos Ilias I, Statovci Shukrije, Bandati Alexei, Novotni Antoni, Bajraktarov Stojan, Panfil Anca-Livia, Maric Nadja, Delić Mirjana, Jovanović Nikolina
Faculty of Medicine, University of Montenegro; Psychiatric Clinic, Clinical Center of Montenegro, Podgorica, Montenegro.
Psychiatric Clinic, Clinical Center of Montenegro, Podgorica, Montenegro.
Schizophrenia (Heidelb). 2022 Mar 1;8(1):10. doi: 10.1038/s41537-022-00226-y.
This study aimed to analyze treatment guidelines of 12 SEE countries to identify non-pharmacological interventions recommended for schizophrenia, explore the evidence base supporting recommendations, and assess the implementation of recommended interventions. Desk and content analysis were employed to analyze the guidelines. Experts were surveyed across the 12 countries to assess availability of non-pharmacological treatments in leading mental health institutions, staff training, and inclusion in the official service price list. Most SEE countries have published treatment guidelines for schizophrenia focused on pharmacotherapy. Nine countries-Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Moldova, Montenegro, North Macedonia, and Serbia-included non-pharmacological interventions. The remaining three countries-Kosovo (UN Resolution), Romania, and Slovenia-have not published such treatment guidelines, however they are on offer in leading institutions. The median number of recommended interventions was seven (range 5-11). Family therapy and psychoeducation were recommended in most treatment guidelines. The majority of recommended interventions have a negative or mixed randomized controlled trial evidence base. A small proportion of leading mental health institutions includes these interventions in their official service price list. The interventions recommended in the treatment guidelines seem to be rarely implemented within mental health services in the SEE countries.
本研究旨在分析12个东南欧国家的治疗指南，以确定推荐用于精神分裂症的非药物干预措施，探索支持这些推荐的证据基础，并评估推荐干预措施的实施情况。采用案头分析和内容分析法对指南进行分析。对这12个国家的专家进行了调查，以评估主要精神卫生机构中非药物治疗的可用性、工作人员培训情况以及是否列入官方服务价格表。大多数东南欧国家已发布了侧重于药物治疗的精神分裂症治疗指南。九个国家——阿尔巴尼亚、波斯尼亚和黑塞哥维那、保加利亚、克罗地亚、希腊、摩尔多瓦、黑山、北马其顿和塞尔维亚——纳入了非药物干预措施。其余三个国家——科索沃（联合国决议）、罗马尼亚和斯洛文尼亚——尚未发布此类治疗指南，但在主要机构中提供。推荐干预措施的中位数为7项（范围为5 - 11项）。大多数治疗指南都推荐了家庭治疗和心理教育。大多数推荐干预措施的随机对照试验证据基础为阴性或混合性。一小部分主要精神卫生机构将这些干预措施列入其官方服务价格表。治疗指南中推荐的干预措施在东南欧国家的精神卫生服务中似乎很少得到实施。
