Department of Scientific Research, Helen Dowling Institute, Bilthoven, The Netherlands.
Department of Medical Psychology, Alrijne Hospital, Leiden, The Netherlands.
Support Care Cancer. 2023 May 8;31(6):325. doi: 10.1007/s00520-023-07764-w.
With the limited availability of mental healthcare, it is of utmost importance to provide care that matches the needs of patients: short if possible, but also more intense when necessary. This study explored whether Early Maladaptive Schemas (EMSs) play a predictive role in the intensity of needed mental health treatment of cancer-related psychopathology.
EMSs were assessed before mental health treatment in 256 patients who sought help at a specialized mental health care centre for those affected by cancer in the Netherlands. Data about treatment indication and intensity of mental health treatment were collected. Univariate and multivariate logistic regression analysis were used to assess the predictive value of the EMSs total score and specific domains on treatment indication and treatment intensity.
The presence of more severe EMSs predicted an indication for a more intense mental health treatment before start of the treatment, and actual more intense mental health treatment. The domain Impaired Autonomy and Performance appeared to be conceptually close to the domain Disconnection and Rejection, we left the latter out in our multivariate analysis and then found that Impaired Autonomy was the best predictor of intensity of mental health treatment.
Our findings imply that assessing EMSs could help to identify patients who will receive more treatment time.
由于精神卫生保健资源有限,提供符合患者需求的护理至关重要:尽可能简短,但在必要时也更加强烈。本研究探讨了早期适应不良模式(EMS)是否对癌症相关心理病理学的心理健康治疗所需强度具有预测作用。
在荷兰一家专门为癌症患者设立的精神卫生保健中心寻求帮助的 256 名患者在接受心理健康治疗之前评估了 EMS。收集了有关治疗指征和心理健康治疗强度的数据。使用单变量和多变量逻辑回归分析评估 EMS 总分和特定领域对治疗指征和治疗强度的预测价值。
更严重的 EMS 存在预示着在开始治疗之前需要更强烈的心理健康治疗,以及实际更强烈的心理健康治疗。自主性和表现受损的领域似乎与脱节和拒绝的领域概念上接近,我们在多变量分析中忽略了后者,然后发现自主性受损是心理健康治疗强度的最佳预测指标。
我们的研究结果表明,评估 EMS 可以帮助识别需要更多治疗时间的患者。