Gergov Vera, Milic Branka, Löffler-Stastka Henriette, Ulberg Randi, Vousoura Eleni, Poulsen Stig
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Front Psychiatry. 2022 Mar 24;13:859042. doi: 10.3389/fpsyt.2022.859042. eCollection 2022.
Psychotic disorders are commonly accompanied by intense psychological burden, and psychological interventions are usually needed in order to reduce the symptoms and help in maintaining or improving the level of psychological and social functioning after the onset of psychosis. The evidence-base for treating young people at risk for psychosis and adults with psychotic disorders is accumulating. Yet, pervasive systematic literature reviews that would include patients from the full age range being the most essential period for the risk of developing a psychotic disorder, a wide range of psychological interventions, and various types of clinical trials, have been lacking. The aim of this systematic review is to fill the gap by presenting the current research evidence from clinical trials on the effectiveness of psychological interventions for treating young people (12-30) with psychotic disorders.
A systematic search was conducted in PubMed and PsycINFO followed by a 3-step screening process based on the PICOS strategy. Risk of bias of the included studies was assessed by the Mixed Methods Appraisal Tool (MMAT). Extracted data from the included studies is reported using a narrative synthesis.
Of the 1,449 publications screened, 40 from 25 studies were included in the review. Of these, 10 studies reported results from cognitive or behavioral therapy, nine from cognitive remediation therapy (CRT), and six from other types of therapies (i.e., integrative interventions combining psychoeducation and family/group interventions). All but one study found the target interventions to be effective, but the results mostly did not differ significantly from the control conditions in reducing symptoms and improving functioning, preventing relapses and hospitalization, or improving psychological or family variables. The most consistent findings were from CRT, showing more improvement in cognitive functioning compared to control conditions while not being superior in reducing symptom severity. Integrative interventions might be effective in treating young people suffering from psychotic disorders.
There is some evidence that psychological interventions are effective for young people with psychotic disorders. However, with regard to symptom severity, psychotherapy does not outperform control conditions, and the results do not strongly favor any specific type of treatment.
[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020166756], identifier [CRD42020166756].
精神障碍通常伴随着强烈的心理负担，因此通常需要进行心理干预，以减轻症状，并有助于在精神病发作后维持或改善心理和社会功能水平。针对有精神病风险的年轻人和患有精神障碍的成年人进行治疗的证据正在不断积累。然而，全面的系统文献综述却一直缺失，这类综述应涵盖处于患精神病风险最高时期的所有年龄段患者、广泛的心理干预措施以及各类临床试验。本系统综述的目的是通过展示来自临床试验的当前研究证据，填补这一空白，这些证据涉及心理干预对治疗患有精神障碍的年轻人（12 - 30岁）的有效性。
在PubMed和PsycINFO中进行了系统检索，随后基于PICOS策略进行了三步筛选过程。使用混合方法评估工具（MMAT）评估纳入研究的偏倚风险。从纳入研究中提取的数据采用叙述性综合报告。
在筛选的1449篇出版物中，本综述纳入了来自25项研究的40篇。其中，10项研究报告了认知或行为疗法的结果，9项来自认知康复疗法（CRT），6项来自其他类型的疗法（即结合心理教育和家庭/团体干预的综合干预措施）。除一项研究外，所有研究均发现目标干预措施有效，但在减轻症状、改善功能、预防复发和住院，或改善心理或家庭变量方面，结果大多与对照条件无显著差异。最一致的发现来自CRT，与对照条件相比，其在认知功能改善方面表现更优，但在减轻症状严重程度方面并不优于对照。综合干预措施可能对治疗患有精神障碍的年轻人有效。
有一些证据表明心理干预对患有精神障碍的年轻人有效。然而，就症状严重程度而言，心理治疗并不优于对照条件，且结果并不强烈支持任何特定类型的治疗。
[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020166756]，标识符[CRD42020166756]
