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基于优势的认知行为疗法和同伴支持在精神分裂症患者康复过程中的应用:一项随机对照试验。

Strength-based cognitive-behavioural therapy and peer-to-peer support in the recovery process for people with schizophrenia: A randomised control trial.

机构信息

Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong.

Melbourne Graduate School of Education, The University of Melbourne, Parkville, Victoria, Australia.

出版信息

Int J Soc Psychiatry. 2024 Mar;70(2):364-377. doi: 10.1177/00207640231212096. Epub 2023 Nov 30.

Abstract

BACKGROUND AND AIMS

Dysfunctional cognition and negative symptoms in schizophrenia are associated with persistently low social functioning and quality of life (QoL). Recovery interventions report only a modest effect in improving social functioning and QoL. This study examined the therapeutic effects and pathways of interventions using strength-based cognitive-behavioural therapy (SBCBT) and peer-to-peer support (PSP) approaches.

METHODS

A randomised control trial compared SBCBT, PSP and TAU (treatment-as-usual) by recruiting 127 individuals with schizophrenia spectrum disorders and low social functioning.

RESULTS

The three-group comparison found SBCBT produced improved social functioning and social support at post-intervention and 6-month follow-up while PSP reported improved social QoL and defeatist beliefs, but none remained at 6-month follow-up. Unsurprising, no improvement was found in any areas for TAU, both at post-test and 6-month follow-up. Regarding mechanisms of change, improvements in hope and personal recovery consistently and significantly accounted for improvements in social functioning and many aspects of QoL of participants, thus indicating the important contribution of hope and personal recovery in strength-based interventions for people with schizophrenia.

CONCLUSION

This rigorously designed study provides the first few solid empirical evidence on the effectiveness of SBCBT and PSP in recovery from schizophrenia and provides initial evidence of the linkage between dysfunctional cognition, hope and recovery in schizophrenia.

摘要

背景和目的

精神分裂症患者认知功能障碍和负性症状与持续较低的社会功能和生活质量(QoL)有关。恢复干预措施仅能适度改善社会功能和生活质量。本研究通过使用基于优势的认知行为疗法(SBCBT)和同伴支持(PSP)方法,考察了干预措施的治疗效果和作用途径。

方法

一项随机对照试验通过招募 127 名精神分裂症谱系障碍和社会功能低下的个体,比较了 SBCBT、PSP 和 TAU(常规治疗)。

结果

三组比较发现,SBCBT 在干预后和 6 个月随访时改善了社会功能和社会支持,而 PSP 则报告了社会 QoL 和失败信念的改善,但在 6 个月随访时均未改善。不出所料,TAU 在任何方面都没有改善,无论是在测试后还是 6 个月随访时。关于变化机制,希望和个人康复的改善始终显著解释了参与者社会功能和许多生活质量方面的改善,这表明希望和个人康复在精神分裂症患者基于优势的干预中的重要贡献。

结论

这项精心设计的研究为 SBCBT 和 PSP 在精神分裂症康复中的有效性提供了一些初步的有力实证证据,并提供了精神分裂症中认知功能障碍、希望和康复之间联系的初步证据。

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