Grossman-Giron Ariella, Maoz Hagai, Nitzan Uri, Kivity Yogev, Zilcha-Mano Sigal, Bloch Yuval, Mendlovic Shlomo, Tzur Bitan Dana
Department of Behavioral Sciences, Ariel University, Ariel, Israel.
Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
Neuropsychobiology. 2023;82(1):14-23. doi: 10.1159/000528314. Epub 2023 Jan 5.
In recent years, several studies were conducted to explore the potential augmenting effect of oxytocin for the treatment of individuals with severe mental illness. Nonetheless, studies exploring its effects in routine inpatient settings using high-quality randomized controlled trials are scarce. The current study assessed the effect of oxytocin administration on treatment process and outcome among psychiatric inpatients, while employing a rigorous experimental methodology.
A double-blind, placebo-controlled, randomized trial was conducted at a public psychiatric hospital in Israel. Patients (N = 87, 71.3% female participants) were administered intranasal oxytocin/placebo twice daily for 4 weeks, as add-on to usual care. Patients were assessed for severity of anxiety and depression symptoms and their working alliance with their therapist after each therapy session, and treatment outcome was assessed weekly. Multilevel modeling was performed to assess the linear change from pre- to post-treatment.
Patients receiving OT demonstrated significantly larger symptomatic improvements (B = -0.01, t [437] = -2.36, p = 0.01). Larger gains were also observed for depression (B = -0.14, p < 0.001 in the OT group, B = -0.06, p = 0.02 in the placebo group) and general distress (B = -0.57, p < 0.001 in the OT group, B = -0.29, p = 0.02 in the placebo group). No significant effect was observed for anxiety, the working alliance, or attachment.
Oxytocin has the potential to improve treatment outcome among inpatients. Nonetheless, additional controlled research is needed to further assess its effects on therapy process, as well as to account for therapeutic, pharmacological, and neuronal intervening factors.
近年来，开展了多项研究以探索催产素对治疗重症精神疾病患者的潜在增强作用。尽管如此，利用高质量随机对照试验在常规住院环境中探索其效果的研究却很匮乏。本研究采用严格的实验方法，评估了催产素给药对精神科住院患者治疗过程及结局的影响。
在以色列一家公立精神病医院进行了一项双盲、安慰剂对照的随机试验。患者（N = 87，女性参与者占71.3%）在接受常规护理的基础上，每天两次经鼻给予催产素/安慰剂，持续4周。每次治疗 session 后评估患者的焦虑和抑郁症状严重程度及其与治疗师的工作联盟情况，每周评估治疗结局。进行多水平建模以评估治疗前至治疗后的线性变化。
接受催产素治疗的患者症状改善显著更大（B = -0.01，t[437] = -2.36，p = 0.01）。在抑郁方面也观察到更大的改善（催产素组B = -0.14，p < 0.001；安慰剂组B = -0.06，p = 0.02）以及一般痛苦程度（催产素组B = -0.57，p < 0.001；安慰剂组B = -0.29，p = 0.02）。在焦虑、工作联盟或依恋方面未观察到显著影响。
催产素有可能改善住院患者的治疗结局。尽管如此，仍需要进一步的对照研究来进一步评估其对治疗过程的影响，以及考虑治疗、药理和神经干预因素。
