Herman Yarissa, Norouzian Nikoo, MacKenzie Lynn E
Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Department of Psychology, York University, Toronto, Ontario, Canada.
Early Interv Psychiatry. 2023 Mar;17(3):311-318. doi: 10.1111/eip.13337. Epub 2022 Aug 6.
Approximately 50% of individuals with first-episode psychosis meet criteria for a substance use disorder and these concurrent disorders are associated with worse long-term outcomes. Psychosocial interventions, including motivational interviewing as well as cognitive and behavioural therapies, have shown some evidence for effective treatment in substance use disorders; however, there is a paucity of existing studies that have successfully examined these interventions in first-episode psychosis.
Participants (n = 64) received the concurrent disorders intervention, which included individual support alongside participation in at least one of two groups: a 4-week Motivational Engagement group utilizing motivational interviewing (n = 59) and an 8-week Relapse Prevention Training group emphasizing skill acquisition, which some participants entered directly (n = 5) and some participants entered following completion of the Motivational Engagement group (n = 16).
Participants who completed the Motivational Engagement group (n = 59) demonstrated significantly increased motivation to change substance use (d = -.0.58; t = -3.02, p < .01) and significantly decreased substance use frequency (d = 0.65; t = 3.26, p < .01). For participants who completed the Relapse Prevention Training group (n = 21), substance use frequency significantly decreased (d = 0.92; t = 3.46, p < .01) and self-efficacy in one's ability to maintain substance use changes significantly increased (d = -0.85; t = -3.59, p < .01).
This pilot evaluation suggests that motivational interviewing and relapse prevention skills training are acceptable and feasible interventions in the treatment of substance use disorders in young adults with first-episode psychosis.
约50%的首发精神病患者符合物质使用障碍的标准，这些共病与更差的长期预后相关。心理社会干预，包括动机性访谈以及认知和行为疗法，已显示出在物质使用障碍有效治疗方面的一些证据；然而，现有研究中很少有成功针对首发精神病患者检验这些干预措施的。
参与者（n = 64）接受共病干预，包括个人支持以及参与以下两个组中的至少一组：一个为期4周的采用动机性访谈的动机参与组（n = 59）和一个为期8周的强调技能习得的预防复发训练组，一些参与者直接进入该组（n = 5），一些参与者在完成动机参与组后进入该组（n = 16）。
完成动机参与组的参与者（n = 59）表现出改变物质使用的动机显著增加（d = -0.58；t = -3.02，p <.01），物质使用频率显著降低（d = 0.65；t = 3.26，p <.01）。对于完成预防复发训练组的参与者（n = 21），物质使用频率显著降低（d = 0.92；t = 3.46，p <.01），维持物质使用改变能力的自我效能显著提高（d = -0.85；t = -3.59，p <.01）。
这项初步评估表明，动机性访谈和预防复发技能训练是治疗首发精神病青年成人物质使用障碍可接受且可行的干预措施。
