Molander Olof, Bjureberg Johan, Sahlin Hanna, Beijer Ulla, Hellner Clara, Ljótsson Brjánn
PelarbackenErsta Diakoni, Social Welfare Office for the Homeless, City of Stockholm, Stockholm, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69, Plan 7, 113 64, Stockholm, Sweden.
Pilot Feasibility Stud. 2023 May 5;9(1):76. doi: 10.1186/s40814-023-01305-2.
Homelessness is associated with high prevalence of psychiatric disorders such as substance use disorders, including alcohol use disorder, and depression.
This case series and feasibility trial evaluated a novel integrated cognitive behavioral treatment (ICBT), which was adapted specifically for homeless individuals and developed to treat substance use and depressive symptoms simultaneously. The ICBT was delivered among four homeless individuals enrolled in the Treatment First program (a social services program where treatment is offered in conjunction with temporary transitional housing), who had access to stable and sober housing milieus.
The ICBT was rated high in expectancy of improvement, credibility, and satisfaction, with few treatment-related adverse events, and fairly high treatment retention. At 12 months follow-up, three of four participants were not homeless anymore. Some participants experienced short-term reductions in substance use and/or depressive symptoms.
The study provided preliminary support that the ICBT can be a feasible and potentially effective treatment for homeless individuals with substance use and/or depressive symptoms. However, the delivery format within the Treatment First program was not feasible. The ICBT could be offered within the social services Housing First program instead (where permanent housing is offered before treatment), or to non-homeless individuals.
The study was registered retrospectively at ClinicalTrials.gov (NCT05329181).
无家可归与精神疾病的高患病率相关，如物质使用障碍，包括酒精使用障碍和抑郁症。
本病例系列和可行性试验评估了一种新型综合认知行为疗法（ICBT），该疗法专门针对无家可归者进行了调整，旨在同时治疗物质使用和抑郁症状。ICBT在参加“治疗优先”项目（一个社会服务项目，在提供治疗的同时提供临时过渡性住房）的四名无家可归者中实施，这些人能够入住稳定且无毒品的住房环境。
ICBT在改善预期、可信度和满意度方面获得高分，治疗相关不良事件较少，治疗保留率相当高。在12个月的随访中，四名参与者中有三名不再无家可归。一些参与者的物质使用和/或抑郁症状出现了短期减轻。
该研究提供了初步支持，表明ICBT对于有物质使用和/或抑郁症状的无家可归者可能是一种可行且有效的治疗方法。然而，“治疗优先”项目中的实施形式不可行。ICBT可改为在社会服务“住房优先”项目（在治疗前提供永久住房）中提供，或提供给非无家可归者。
该研究在ClinicalTrials.gov上进行了回顾性注册（NCT05329181）。
