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一种新的简短心理疗法(处理异常感觉体验)对首发精神病性幻觉的效果(MUSE FEP):一项探索性随机对照试验的结果。

Effects of a novel, brief psychological therapy (Managing Unusual Sensory Experiences) for hallucinations in first episode psychosis (MUSE FEP): Findings from an exploratory randomised controlled trial.

机构信息

Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, United Kingdom; Department of Psychology, University of York, YO10 5DD, United Kingdom.

Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, United Kingdom.

出版信息

J Psychiatr Res. 2024 Jun;174:289-296. doi: 10.1016/j.jpsychires.2024.04.031. Epub 2024 Apr 16.

DOI:10.1016/j.jpsychires.2024.04.031
PMID:38678686
Abstract

Hallucinations are a common feature of psychosis, yet access to effective psychological treatment is limited. The Managing Unusual Sensory Experiences for First-Episode-Psychosis (MUSE-FEP) trial aimed to establish the feasibility and acceptability of a brief, hallucination-specific, digitally provided treatment, delivered by a non-specialist workforce for people with psychosis. MUSE uses psychoeducation about the causal mechanisms of hallucinations and tailored interventions to help a person understand and manage their experiences. We undertook a two-site, single-blind (rater) Randomised Controlled Trial and recruited 82 participants who were allocated 1:1 to MUSE and treatment as usual (TAU) (n = 40) or TAU alone (n = 42). Participants completed assessments before and after treatment (2 months), and at follow up (3-4 months). Information on recruitment rates, adherence, and completion of outcome assessments was collected. Analyses focussed on feasibility outcomes and initial estimates of intervention effects to inform a future trial. The trial is registered with the ISRCTN registry 16793301. Criteria for the feasibility of trial methodology and intervention delivery were met. The trial exceeded the recruitment target, had high retention rates (87.8%) at end of treatment, and at follow up (86.6%), with good acceptability of treatment. There were 3 serious adverse events in the therapy group, and 5 in the TAU group. Improvements were evident in both groups at the end of treatment and follow up, with a particular benefit in perceived recovery in the MUSE group. We showed it was feasible to increase access to psychological intervention but a definitive trial requires further changes to the trial design or treatment.

摘要

幻觉是精神病的常见特征,但获得有效的心理治疗的机会有限。Managing Unusual Sensory Experiences for First-Episode-Psychosis (MUSE-FEP) 试验旨在验证一种简短的、针对幻觉的、数字化提供的治疗方法的可行性和可接受性,该治疗方法由非专业人员提供,适用于精神病患者。MUSE 使用关于幻觉因果机制的心理教育和量身定制的干预措施,帮助患者理解和管理他们的体验。我们进行了一项两站点、单盲(评估者)随机对照试验,招募了 82 名参与者,他们被随机分配到 MUSE 和常规治疗(TAU)(n=40)或单独接受 TAU(n=42)。参与者在治疗前(2 个月)、治疗后和随访(3-4 个月)时完成评估。收集了有关招募率、依从性和完成结果评估的信息。分析集中在可行性结果和干预效果的初步估计上,以为未来的试验提供信息。该试验在 ISRCTN 注册中心注册,注册号为 ISRCTN81250325。试验方法和干预措施的可行性标准得到了满足。试验超过了招募目标,在治疗结束时和随访时(86.6%)保留率很高,治疗的可接受性良好。治疗组有 3 例严重不良事件,TAU 组有 5 例。两组在治疗结束和随访时都有明显的改善,MUSE 组在感知康复方面的获益尤其明显。我们证明了增加获得心理干预的机会是可行的,但需要对试验设计或治疗方法进行进一步的改变,才能进行确定性试验。

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