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严重精神疾病与物质滥用患者心理社会干预的脱落率:系统评价与荟萃分析

Dropout Rates in Psychosocial Interventions for People With Both Severe Mental Illness and Substance Misuse: A Systematic Review and Meta-Analysis.

作者信息

Bouchard Marianne, Lecomte Tania, Cloutier Briana, Herrera-Roberge Jessica, Potvin Stéphane

机构信息

Department of Psychology, University of Montreal, Montréal, QC, Canada.

Centre de recherche de l'Institut Universitaire en Santé mentale de Montréal, Montreal, QC, Canada.

出版信息

Front Psychiatry. 2022 May 12;13:842329. doi: 10.3389/fpsyt.2022.842329. eCollection 2022.

Abstract

INTRODUCTION

Over the years, many psychosocial interventions for individual having both a psychotic spectrum disorder and a substance use disorder diagnoses have been developed and studied. However, there is a high dropout rate among this clinical population.

OBJECTIVES

This meta-analysis aims to replicate a previous meta-analysis on the effects of psychosocial treatment for dual disorders, while including and determining the dropout rates in those type of interventions.

METHOD

Based on a Cochrane systematic review conducted in 2019, we conducted a meta-analysis including 40 randomized clinical trials on psychosocial treatment among persons suffering from schizophrenia spectrum disorder and substance use disorder.

RESULTS

A dropout rate of 27,2% was obtained. Stimulants use significantly affected dropout rates. Age, gender, diagnosis, alcohol and cannabis abuse, and duration of treatment did not affect dropout rates.

CONCLUSION

The 27,2% rate of dropout from psychosocial treatment highlights the need to engage participants having a dual diagnosis from the start by focusing on therapeutic alliance and motivation for treatment.

摘要

引言

多年来,针对患有精神分裂症谱系障碍和物质使用障碍双重诊断的个体,已经开发并研究了许多心理社会干预措施。然而,这一临床人群的脱落率很高。

目的

本荟萃分析旨在重复先前关于双重障碍心理社会治疗效果的荟萃分析,同时纳入并确定这类干预措施中的脱落率。

方法

基于2019年进行的一项Cochrane系统评价,我们进行了一项荟萃分析,纳入了40项关于精神分裂症谱系障碍和物质使用障碍患者心理社会治疗的随机临床试验。

结果

脱落率为27.2%。使用兴奋剂显著影响脱落率。年龄、性别、诊断、酒精和大麻滥用以及治疗持续时间均不影响脱落率。

结论

心理社会治疗27.2%的脱落率凸显了从一开始就通过关注治疗联盟和治疗动机来促使双重诊断参与者参与治疗的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25b8/9133375/5304066f3f43/fpsyt-13-842329-g0001.jpg

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