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精神障碍患者居家治疗的疗效——一项研究综述

Efficacy of home treatment of patients with mental disorders - a research review.

作者信息

Hat Marta, Cechnicki Andrzej

机构信息

Psychosis Research Unit, Association for the Development of Community Psychiatry and Care, Krakow, Poland.

Community Psychiatry and Psychosis Research Center, Chair of Psychiatry, Jagiellonian University Medical College, Krakow, Poland.

出版信息

Postep Psychiatr Neurol. 2021 Mar;30(1):21-36. doi: 10.5114/ppn.2021.106817. Epub 2021 Jun 10.


DOI:10.5114/ppn.2021.106817
PMID:37082031
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9881613/
Abstract

PURPOSE: The aim of this study is to review research on the efficacy of home treatment for mental disorders compared to other forms of community-based treatment. The first section describes studies comparing treatment as usual with CMHT (Community Mental Health Team), the second section compares CMHT with more intensive forms of community-based care, such as CM (Case Management) and ACT (Assertive Community Treatment, and the third section focuses on interventions that are alternatives to hospitalization, described as CRT or MCHT (Crisis Resolution Team or Mobile Crisis Home Treatment). VIEWS: The community-based model of psychiatric health care is nowadays recognized as the best systemic solution to improve its organization and functioning. In comprehensive care in the community, home treatment plays an important role. Treatment teams most often take the form of a general Community Mental Health Team - CMHT, which, like community mental health services in Poland, provides a wide range of interventions. There are several forms of treatment within CMHTs: ACT, CM, CRT and MHCT. COMMENT: Home treatment is more effective compared to standard inpatient and post-hospital care. Care under a Community Mental Health Team reduces the number and duration of hospitalizations and is characterized by higher treatment satisfaction. For patients with psychotic disorders, more intensive forms of community-based care - such as ACT, CM, and CRT - are particularly valuable and effective.

摘要

目的:本研究旨在回顾与其他形式的社区治疗相比,家庭治疗对精神障碍疗效的研究。第一部分描述了将常规治疗与社区精神卫生团队(CMHT)进行比较的研究,第二部分将CMHT与更强化的社区护理形式进行比较,如个案管理(CM)和积极社区治疗(ACT),第三部分重点关注作为住院替代方案的干预措施,称为危机解决团队(CRT)或移动危机家庭治疗(MCHT)。 观点:如今,基于社区的精神卫生保健模式被认为是改善其组织和功能的最佳系统解决方案。在社区综合护理中,家庭治疗起着重要作用。治疗团队通常采取一般社区精神卫生团队——CMHT的形式,与波兰的社区精神卫生服务一样,提供广泛的干预措施。CMHT中有几种治疗形式:ACT、CM、CRT和MHCT。 评论:与标准住院治疗和出院后护理相比,家庭治疗更有效。在社区精神卫生团队的护理可减少住院次数和住院时间,且治疗满意度更高。对于患有精神障碍的患者,更强化的社区护理形式——如ACT、CM和CRT——特别有价值且有效。

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引用本文的文献

[1]
Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland.

Front Psychiatry. 2022-1-7

本文引用的文献

[1]
Reduction of Involuntary Admissions in Patients With Severe Psychotic Disorders Treated in the ACCESS Integrated Care Model Including Therapeutic Assertive Community Treatment.

Front Psychiatry. 2019-10-24

[2]
Suicide attempts in people with schizophrenia before and after participating in an intensive case managed community program: A 20-year follow-up.

Psychiatry Res. 2019-7-10

[3]
The CORE service improvement programme for mental health crisis resolution teams: results from a cluster-randomised trial.

Br J Psychiatry. 2020-6

[4]
Do Home-Based Psychiatric Services for Patients in Medico-Social Institutions Reduce Hospitalizations? Pre-Post Evaluation of a French Psychiatric Mobile Team.

Psychiatr Q. 2019-3

[5]
Intensive home treatment for patients in acute psychiatric crisis situations: a multicentre randomized controlled trial.

BMC Psychiatry. 2018-2-27

[6]
Scales for assessing patient satisfaction with mental health care: A systematic review.

J Psychiatr Res. 2018-2-19

[7]
The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry.

Int J Environ Res Public Health. 2017-3-21

[8]
Comprehensive Versus Usual Community Care for First-Episode Psychosis: 2-Year Outcomes From the NIMH RAISE Early Treatment Program.

Am J Psychiatry. 2016-4-1

[9]
Implementation of the Crisis Resolution Team model in adult mental health settings: a systematic review.

BMC Psychiatry. 2015-4-8

[10]
Psychosocial treatments for schizophrenia.

Annu Rev Clin Psychol. 2013-1-16

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