PsyCARE 研究：评估意大利卫生部“心理奖金”政策的影响、成本效益和跨诊断因素。

PsyCARE study: assessing impact, cost-effectiveness, and transdiagnostic factors of the Italian ministry of health's "psychological bonus" policy.

机构信息

Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.

Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.

出版信息

BMC Psychol. 2023 Oct 5;11(1):306. doi: 10.1186/s40359-023-01345-6.

DOI:10.1186/s40359-023-01345-6

PMID:37798802

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10557166/

Abstract

BACKGROUND

The prevalence of anxiety and depression disorders is surging worldwide, prompting a pressing demand for psychological interventions, especially in less severe cases. Responding to this need, the Italian government implemented the "Psychological Bonus" (PB) policy, allotting 25 million euros for mental health support. This policy entitles individuals to a minimum of four to twelve psychological sessions. In collaboration with the National Board of Italian Psychologists, our study assesses this policy's effectiveness. Indeed, the PsyCARE study aims to examine the utilization of the Psychological Bonus, evaluate its impact on adult and adolescent participants' psychological well-being through pre- and post-intervention assessments and six-month follow-up, and conduct a longitudinal cost-effectiveness analysis of this policy. A secondary aim is to investigate the influence of these interventions on transdiagnostic factors, including emotion regulation and epistemic trust.

METHODS

The study involves licensed psychotherapists and their patients, both adults and adolescents, benefiting from the Psychological Bonus. Data collection is underway and set to conclude in December 2023. Psychotherapists will provide diagnostic information and assess patient functioning. In addition, patients will be evaluated on mental health aspects such as clinical symptoms, emotion regulation, epistemic trust, and quality of life. We will employ linear mixed-effects models to analyze the outcomes, accounting for both fixed and random effects to capture the hierarchical structure of the data.

DISCUSSION

We anticipate the study's findings will highlight reduced psychological distress and improved quality of life for participants and demonstrate the Psychological Bonus policy's cost-effectiveness. The study will gather data on the role of specific versus nonspecific therapeutic factors in psychotherapy while adopting a patient-tailored approach to identify effective therapeutic elements and examine transdiagnostic factors. Overall, this study's findings will guide future measures within the Italian healthcare system, fostering a psychological health culture and providing valuable insights to the broader public.

STUDY REGISTRATION

https://osf.io/6zk2j.

摘要

背景

焦虑和抑郁障碍的患病率在全球范围内呈飙升趋势，因此迫切需要心理干预措施，尤其是在病情不太严重的情况下。为了满足这一需求，意大利政府实施了“心理奖金”（PB）政策，拨款 2500 万欧元用于心理健康支持。该政策允许个人获得至少四到十二次的心理治疗。我们的研究与意大利国家心理学家委员会合作，评估了该政策的有效性。实际上，PsyCARE 研究旨在评估“心理奖金”的使用情况，通过干预前后的评估和六个月的随访，评估其对成年和青少年参与者心理健康的影响，并对该政策进行纵向成本效益分析。次要目标是研究这些干预措施对跨诊断因素（包括情绪调节和认知信任）的影响。

方法

研究涉及受益于“心理奖金”的持照心理治疗师及其成年和青少年患者。数据收集正在进行中，预计将于 2023 年 12 月结束。心理治疗师将提供诊断信息并评估患者的功能。此外，患者将在心理健康方面进行评估，如临床症状、情绪调节、认知信任和生活质量。我们将使用线性混合效应模型分析结果，同时考虑固定效应和随机效应，以捕捉数据的层次结构。

讨论

我们预计研究结果将表明参与者的心理困扰减少，生活质量提高，并证明“心理奖金”政策具有成本效益。该研究将收集关于特定与非特定治疗因素在心理治疗中的作用的数据，同时采用患者量身定制的方法来确定有效的治疗元素，并研究跨诊断因素。总的来说，这项研究的结果将为意大利医疗保健系统提供未来措施的指导，培养一种心理健康文化，并为更广泛的公众提供有价值的见解。