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精神病日间医院中的接纳与承诺疗法——一项纵向自然主义疗效试验。

Acceptance and commitment therapy in a psychiatric day hospital-A longitudinal naturalistic effectiveness trial.

作者信息

Rutschmann Ronja, Romanczuk-Seiferth Nina, Richter Christoph

机构信息

Clinic for Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Kaulsdorf, Berlin, Germany.

Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Berlin, Germany.

出版信息

Front Psychiatry. 2023 Jan 11;13:1052874. doi: 10.3389/fpsyt.2022.1052874. eCollection 2022.

Abstract

OBJECTIVES

Despite the transdiagnostic approach and the good cross-professional applicability, only few studies have examined the effects of Acceptance and Commitment Therapy (ACT) in a naturalistic clinic setting. This study aims to help closing this gap by investigating the effects of ACT in a psychiatric day hospital during COVID pandemic. It was investigated whether psychopathological symptomology decreased, and quality of life and general functioning improved with the treatment. Additionally, longitudinal effects were tested.

METHODS

Participants in this follow-up-design were 92 patients (64.1% female) of a psychiatric day hospital. Survey data of clinical symptoms, quality of life and global functioning were assessed at three time points (with admission, discharge, and 3 months after treatment). Differences between time points were tested using two-sided paired samples -tests. Additionally, the reliability of change index (RCI) was calculated.

RESULTS

From pre-treatment to post-treatment, symptomology decreased significantly ( = 0.82-0.99, < 0.001), and global functioning as well as quality of life increased significantly ( = 0.42-1.19, < 0.001). The effects remained relatively stable, with no significant change between post-treatment and follow-up. The difference between pre-treatment and follow-up was significant for clinical symptoms, physical and psychological wellbeing, and global quality of life ( = 0.43-0.76, < 0.007).

CONCLUSION

The significant and sustained improvement in all measures indicates that patients are benefiting from the treatment. Since the trial was neither randomized nor controlled, effects have to be interpreted with caution. Possible influences of the pandemic are discussed.

CLINICAL TRIAL REGISTRATION

http://www.drks.de/DRKS00029992, identifier DRKS00029992.

摘要

目的

尽管采用了跨诊断方法且具有良好的跨专业适用性,但只有少数研究在自然主义的临床环境中检验了接纳与承诺疗法(ACT)的效果。本研究旨在通过调查新冠疫情期间精神病日间医院中ACT的效果来填补这一空白。研究了心理病理症状学是否减轻,以及治疗后生活质量和总体功能是否改善。此外,还测试了纵向效应。

方法

本随访设计的参与者为一家精神病日间医院的92名患者(64.1%为女性)。在三个时间点(入院时、出院时和治疗后3个月)评估临床症状、生活质量和整体功能的调查数据。使用双侧配对样本检验来测试时间点之间的差异。此外,还计算了变化指数(RCI)的可靠性。

结果

从治疗前到治疗后,症状学显著减轻(=0.82 - 0.99,<0.001),整体功能和生活质量显著提高(=0.42 - 1.19,<0.001)。效果保持相对稳定,治疗后与随访之间无显著变化。治疗前与随访之间在临床症状、身心健康和总体生活质量方面的差异显著(=0.43 - 0.76,<0.007)。

结论

所有指标的显著且持续改善表明患者从治疗中受益。由于该试验既未随机分组也未设对照,对结果的解释需谨慎。讨论了疫情可能产生的影响。

临床试验注册

http://www.drks.de/DRKS00029992,标识符DRKS00029992。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/9874115/7be659d8ab9a/fpsyt-13-1052874-g001.jpg

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