新型跨诊断生态即时干预对预防和早期干预青年严重精神障碍的效果（EMIcompass）：一项探索性随机对照试验的结果。
Effects of a Novel, Transdiagnostic Ecological Momentary Intervention for Prevention, and Early Intervention of Severe Mental Disorder in Youth (EMIcompass): Findings From an Exploratory Randomized Controlled Trial.
机构信息
Department of Public Mental Health, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
出版信息
Schizophr Bull. 2023 May 3;49(3):592-604. doi: 10.1093/schbul/sbac212.
BACKGROUND/HYPOTHESIS: Digital interventions targeting transdiagnostic mechanisms in daily life may be a promising translational strategy for prevention and early intervention of psychotic and other severe mental disorders. We aimed to investigate the feasibility and initial signals of efficacy of a transdiagnostic, compassion-focused, hybrid ecological momentary intervention for improving resilience (ie, EMIcompass) in youth with early mental health problems.
STUDY DESIGN
In an exploratory, assessor-blind randomized controlled trial, youth aged 14-25 with current distress, broad at-risk mental state, or first episode of severe mental disorder were randomly allocated to experimental (EMIcompass+treatment as usual [TAU]) or control condition (TAU). Data on primary (stress reactivity) and secondary candidate mechanisms as well as candidate primary (psychological distress) and secondary outcomes were collected.
STUDY RESULTS
Criteria for the feasibility of trial methodology and intervention delivery were met (n = 92 randomized participants). No serious adverse events were observed. Initial outcome signals were evident for reduced momentary stress reactivity (stress×time×condition, B = -0.10 95%CI -0.16--0.03, d = -0.10), aberrant salience (condition, B = -0.38, 95%CI -0.57--0.18, d = -0.56) as well as enhanced momentary resilience (condition, B = 0.55, 95%CI 0.18-0.92, d = 0.33) and quality of life (condition, B = 0.82, 95%CI 0.10-1.55, d = 0.60) across post-intervention and 4-week follow-up. No outcome signals were observed for self-reported psychological distress (condition, B = 0.57, 95%CI -1.59-2.72, d = 0.09), but there was suggestive evidence of reduced observer-rated symptoms at the 4-week follow-up (B = -1.41, 95%CI -2.85-0.02, d = -0.41).
CONCLUSIONS
Our findings provide evidence of feasibility and initial signals that EMIcompass may reduce stress reactivity and improve quality of life. A definitive trial is now warranted.
背景/假设：针对日常生活中转诊断机制的数字干预措施可能是预防和早期干预精神病和其他严重精神障碍的一种有前途的转化策略。我们旨在研究一种针对转诊断、以同情心为重点、混合生态瞬间干预措施（即 EMIcompass）改善弹性（即 EMIcompass）的可行性和初步疗效信号，该干预措施针对有早期心理健康问题的年轻人。
研究设计
在一项探索性、评估者盲的随机对照试验中，年龄在 14-25 岁之间、当前有压力、广泛的高危精神状态或首次出现严重精神障碍的年轻人被随机分配到实验组（EMIcompass+常规治疗[TAU]）或对照组（TAU）。收集了主要（应激反应性）和次要候选机制以及主要候选（心理困扰）和次要结果的数据。
研究结果
试验方法和干预措施的可行性标准得到满足（n=92 名随机参与者）。未观察到严重不良事件。初步结果信号表明，瞬时应激反应性降低（应激×时间×条件，B=-0.10，95%CI-0.16--0.03，d=-0.10）、异常突显（条件，B=-0.38，95%CI-0.57--0.18，d=-0.56）以及瞬间恢复力增强（条件，B=0.55，95%CI0.18-0.92，d=0.33）和生活质量（条件，B=0.82，95%CI0.10-1.55，d=0.60）在干预后和 4 周随访时。自我报告的心理困扰（条件，B=0.57，95%CI-1.59-2.72，d=0.09）未见结果信号，但在 4 周随访时观察到症状减轻的迹象（B=-1.41，95%CI-2.85-0.02，d=-0.41）。
结论
我们的研究结果提供了证据，证明 EMIcompass 可能降低应激反应性并提高生活质量。现在需要进行一项确证性试验。
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