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简短焦点解决疗法对精神分裂症的影响:家庭特征与精神病理学的初步研究。

Brief Solution Focused Therapy on schizophrenia: A preliminary study of family characteristics and psychopathology.

机构信息

Department of Psychiatry, University Hospital of Heraklion, Crete.

DDepartment of Psychiatry, School of Medicine, University of Crete, Heraklion, Crete.

出版信息

Psychiatriki. 2023 Mar 28;34(1):36-43. doi: 10.22365/jpsych.2022.085. Epub 2022 Jul 19.

Abstract

Family therapy for schizophrenia has been demonstrated to be effective and is recommended by international clinical guidelines. Reviews of family therapy research conclude that interventions may prevent relapse of the disease, when symptoms are already reduced under psychotropic medication, by reducing family factors associated with relapse. The purpose of this study was to examine the effectiveness of Brief Solution Focused therapy (BSFT) in patients with schizophrenia focusing on the impact of change in family characteristics such as cohesion, conflict, organization and control on patients' psychopathology measured with BPRS. Thirty patients diagnosed with schizophrenia were randomly assigned to the control or intervention group. The intervention group received treatment according to the BSFT model, whereas the control group received the standard care for schizophrenia. The BSFT is a future-oriented psychotherapy model which encourages clients to focus on ''change-talking'' instead of ''problem-talking'' and on instances where a successful solution has been achieved. The intervention was consisted of 5 sessions delivered in 3 months. Main outcomes were patient-rated family characteristics measured by the Family Environment Scale (FES), and psychiatrist-rated symptom severity measured with the Brief Psychiatric Rating Scale (BPRS). The two groups did not differ in terms of age, sex, number of relapses, previous hospital admissions, and BPRS score at baseline. At the end of treatment compared to baseline there was a reduction of the BPRS score in the intervention group (p<0.001) whereas no statistically significant changes were noticed in the control group after 3 months. Also, following treatment, patients in the intervention group displayed reduced scores on the Conflict FES scale (p=0.001) accompanied by increased scores on the Cohesion (p=0.004), Expressiveness (p=0.004), and Active Recreational subscales (p=0.001) according to patient's perspective. These preliminary findings suggest that BSFT in patients with schizophrenia, appears to be effective in altering the global properties of the whole family system, specifically cohesion, conflict, organization and control which, in turn, have an impact on reducing patient psychopathology.

摘要

家庭治疗精神分裂症已被证明是有效的,并得到国际临床指南的推荐。家庭治疗研究的综述得出结论,干预措施可以通过减少与复发相关的家庭因素,预防疾病的复发,当症状已经在精神药物治疗下减轻时。本研究的目的是检查Brief Solution Focused therapy(BSFT)在精神分裂症患者中的有效性,重点关注家庭特征(如凝聚力、冲突、组织和控制)的变化对患者精神病症状的影响,这些症状用 BPRS 进行测量。30 名被诊断为精神分裂症的患者被随机分配到对照组或干预组。干预组按照 BSFT 模式接受治疗,而对照组则接受精神分裂症的标准护理。BSFT 是一种面向未来的心理治疗模型,鼓励客户专注于“变化谈话”而不是“问题谈话”,以及成功解决问题的实例。干预包括在 3 个月内进行 5 次治疗。主要结果是患者用家庭环境量表(FES)测量的家庭特征,以及精神病医生用简明精神病评定量表(BPRS)测量的症状严重程度。两组在年龄、性别、复发次数、以前的住院次数和基线时的 BPRS 评分方面没有差异。与基线相比,治疗结束时干预组的 BPRS 评分降低(p<0.001),而对照组在 3 个月后没有统计学上的显著变化。此外,治疗后,干预组患者在冲突 FES 量表上的得分降低(p=0.001),同时在凝聚力(p=0.004)、表达力(p=0.004)和积极娱乐子量表(p=0.001)上的得分增加,这是根据患者的观点。这些初步发现表明,BSFT 对精神分裂症患者似乎有效,可以改变整个家庭系统的整体特性,特别是凝聚力、冲突、组织和控制,这反过来又对减轻患者的精神病症状有影响。

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