Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
Health Qual Life Outcomes. 2022 Sep 8;20(1):133. doi: 10.1186/s12955-022-02039-0.
Studies on outcomes mapping Quality of Life (QoL) as patient-reported outcome over a longer period in severe psychotic disorders are scarce. However, such data would be particularly important for structuring, implementing and operating effective and efficient care models and for promoting satisfaction with care, service engagement and adherence.
The ACCESS II study is a prospective long-term study of an integrated care model for people with severe psychotic disorders. The model includes Therapeutic Assertive Community Treatment within a cross-sectoral and interdisciplinary network. This publication analyses the course of QoL assessed with the Q-LES-Q-18 using a mixed model for repeated measures.
Mapping the course of QoL in N = 329 participants, there is a significant increase in the first 6 weeks of treatment (early course). Comparison to a published norm show significant lower QoL for severe psychotic disorders. The variable having a traumatic event before the age of 18 was significantly negatively associated with QoL. A decrease in the severity of depressive as well as in positive symptomatology in the first six weeks after admission was associated with increase of QoL.
Results indicate that the overall symptom burden at time of inclusion is not decisive for the perceived QoL in the long-term course while the reduction in the severity of depressive and positive symptoms is important. This means focusing even more on the treatment of depressive symptoms and include traumatherapeutic aspects in the long-term treatment of severe psychotic disorders if needed.
ClinicalTrials.gov (identifier: NCT01888627).
在严重精神障碍患者中，对较长时间内的生活质量（QoL）作为患者报告的结果进行研究的文献很少。然而，对于构建、实施和运营有效和高效的护理模式，以及提高对护理的满意度、服务参与度和依从性，这些数据将特别重要。
ACCESS II 研究是一项针对严重精神障碍患者综合护理模式的前瞻性长期研究。该模式包括跨部门和跨学科网络内的治疗性坚定社区治疗。本出版物使用重复测量混合模型分析了使用 Q-LES-Q-18 评估的 QoL 轨迹。
在 N=329 名参与者中，对 QoL 轨迹进行分析，发现治疗的前 6 周（早期阶段）有显著增加。与已发表的标准相比，严重精神障碍的 QoL 显著较低。18 岁前有创伤事件的变量与 QoL 显著负相关。入院后前 6 周抑郁和阳性症状严重程度的降低与 QoL 的增加有关。
结果表明，纳入时的整体症状负担对长期病程中的感知 QoL 并不具有决定性，而抑郁和阳性症状严重程度的降低是重要的。这意味着即使在严重精神障碍的长期治疗中，也需要更加关注抑郁症状的治疗，并根据需要纳入创伤治疗方面。
ClinicalTrials.gov（标识符：NCT01888627）。
