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精神分裂症的心理治疗导向型治疗:5年随访结果

Psychotherapeutically oriented treatment of schizophrenia: results of 5-year-follow-up.

作者信息

Alanen Y O, Räkköläinen V, Rasimus R, Laakso J, Kaljonen A

出版信息

Acta Psychiatr Scand Suppl. 1985;319:31-49. doi: 10.1111/j.1600-0447.1985.tb08522.x.

Abstract

The authors have developed a psychotherapeutic approach to schizophrenia within the community psychiatric health care system. The orientation is psychodynamic but global in the meaning that the therapeutic plans are made on the basis of case-specific need of the patients and of their families and include both individual psychotherapy, family therapy and therapeutic communities. The material is composed of 100 successive patients of the schizophrenia group aged 16 - 44 years and for the first time admitted for treatment into the different units of the Turku Mental Health District in 1976 - 77. A multiprofessional staff was acting as therapists, supported by a continuous and intensive on-the-job -training and supervision. The results preliminary reported in this paper are based on a follow-up study 5 years after admission to treatment. 56 patients could be included in the psychotherapy group given at least some mode of psychotherapy in an adequate amount. The background variables of patients selected for various modes of therapy as well as the prognostic results are studied with the aid of logistic regression analyses. The findings indicate that the development of a global psychotherapeutic orientation is possible in the field of community psychiatry and yields results that demonstrate its meaningfulness. The implementation of psychotherapy had clearly positive explanatory connections with a favourable prognosis, and although these connections were not equally strong as the connections of some central clinical and psychosocial variables, they were obvious and manifold.

摘要

作者们已在社区精神卫生保健系统内开发出一种针对精神分裂症的心理治疗方法。其取向是心理动力学的,但具有整体性,这意味着治疗计划是根据患者及其家庭的具体需求制定的,包括个体心理治疗、家庭治疗和治疗社区。研究材料由100例连续的精神分裂症患者组成,年龄在16至44岁之间,于1976 - 1977年首次被收治到图尔库精神卫生区的不同科室。一支多专业的工作人员队伍担任治疗师,同时接受持续且强化的在职培训和督导。本文初步报告的结果基于治疗入院5年后的随访研究。56例患者可纳入心理治疗组,该组患者至少接受了一定量的某种心理治疗模式。借助逻辑回归分析,对选择不同治疗模式的患者的背景变量以及预后结果进行了研究。研究结果表明,在社区精神病学领域开展整体性心理治疗取向是可行的,且所产生的结果证明了其意义。心理治疗的实施与良好预后有着明显的正向解释性关联,尽管这些关联不如一些核心临床和社会心理变量的关联那么强烈,但它们是明显且多方面的。

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