Jaffé Mariela E, Loew Sou Bouy, Meyer Andrea H, Lieb Roselind, Dechent Frieder, Lang Undine E, Huber Christian G, Moeller Julian
University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.
Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland.
Health Serv Insights. 2024 Feb 11;17:11786329241229950. doi: 10.1177/11786329241229950. eCollection 2024.
Treatment guidelines state that evidence-based psychotherapy is effective for people with psychosis and bipolar disorder and should be offered during every phase of the treatment process. However, research has indicated a lack of outpatient psychotherapeutic services for this patient group, for example, in the United States or Germany. We extend this finding by presenting survey data from Switzerland. We surveyed 112 inpatients with a diagnosis of a schizophrenia spectrum disorder or bipolar disorder and assessed outpatient treatment over the 5 years prior to their index hospitalization by using retrospective self-reports. The survey focused on psychotherapy provided by clinical psychologists. Results indicate that only 23.2% of participants retrospectively reported having utilized any outpatient psychotherapy within the reporting period and only 8% of participants reported having received a number of outpatient sessions that reaches recommended levels of psychotherapy. Exploratory analyses did not detect a significant association between self-reported utilization of outpatient psychotherapy sessions and most demographic, psychiatric, and psychological attributes, but patients with a bipolar disorder diagnosis (vs schizophrenia spectrum diagnosis) reported having utilized outpatient treatment more often. These findings are preliminary. When replicated they highlight the need for increased access to outpatient psychotherapy and better alignment between guideline recommendations and outpatient supply.
治疗指南指出,循证心理治疗对患有精神病和双相情感障碍的人有效,且应在治疗过程的每个阶段提供。然而,研究表明,例如在美国或德国,该患者群体缺乏门诊心理治疗服务。我们通过展示来自瑞士的调查数据来扩展这一发现。我们对112名被诊断患有精神分裂症谱系障碍或双相情感障碍的住院患者进行了调查,并通过回顾性自我报告评估了他们在本次住院前5年的门诊治疗情况。该调查聚焦于临床心理学家提供的心理治疗。结果表明,只有23.2%的参与者回顾性报告在报告期内使用过任何门诊心理治疗,只有8%的参与者报告接受的门诊治疗次数达到了推荐的心理治疗水平。探索性分析未发现自我报告的门诊心理治疗疗程使用情况与大多数人口统计学、精神病学和心理学特征之间存在显著关联,但被诊断为双相情感障碍的患者(与精神分裂症谱系诊断相比)报告更频繁地使用门诊治疗。这些发现是初步的。如果得到重复验证,它们凸显了增加门诊心理治疗可及性以及使指南建议与门诊服务供应更好匹配的必要性。