Associazione Italiana per la Diffusione Interventi Psicoeducativi in Salute Mentale - Associazione di Promozione Sociale (AIDIPSaM - APS), Campobasso, Italy.
Dipartimento di Salute Mentale ASL Napoli 1 Centro, Napoli, Italy.
BMC Psychiatry. 2024 Sep 5;24(1):601. doi: 10.1186/s12888-024-06033-2.
Functional Management and Recovery is a standardized Psychoeducational Intervention, derived from "Integro", an effective salutogenic-psychoeducational intervention for people in recovery journey, designed to improve recovery and functioning of individuals with psychotic disorders in Psychiatric Residential Facilities (PRFs). The aim of this study is to evaluate the primary and secondary outcomes of this intervention elaborated specifically for PRFs where evidence based structured interventions seem rare and desirable.
66 individuals with psychotic disorders were recruited in 9 PRFs dislocated in the North, Center and South Italy and 63 underwent a multicenter follow-up study with a two time-point evaluation (t0, pre-treatment and t1, 6 months; ). At each time point, social functioning was assessed as primary outcome by the Personal and Social Performance scale (PSP); furthermore, psychopathological status was assessed by Brief Psychiatric Rating Scale (BPRS), Recovery by Recovery Assessment Scale (RAS), Cognitive Functioning by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Stress management by Stress-Scale, Cognitive Flexibility by Modified Five-Point Test (M-FPT), Emotional Intelligence by Emotional Intelligence Index (EI-I), the PRF Atmosphere and the Opinion of users about the PFR by an ad hoc questionnaire. The Abilities Knowledge, the Utility and Pleasantness of sessions were measured by an ad hoc list of items.
63 individuals out of 66, 52 (82,5%) affected by schizophrenia and 11 (17,5%) by bipolar I disorder with psychotic symptoms according to DSM-5-TR completed the study. At the end of the study, 43 (68,3%) were male, 57 (90.5%) were single, 5 (7.9%) engaged, 1 (1.6%) married; 45 (71.4%) unemployed. The total scores of PSP, RAS, BPRS, BANS, Stress management, Abilities Knowledge, Utility and Pleasantness of sessions showed a statistically significant improvement at t1 vs. t0. Two sub-scales out of 5 of M-FPT showed a statistically significant improvement. The Emotional Intelligence, the Unit Atmosphere and the Opinion of Users about PFR improved without statistical significance. Six months after the end of the follow-up study 22 individuals of the sample were dismissed with a very high turnover.
After a six-month follow-up (a short period of time), these results showed improvement in functioning, the primary outcome, as well as in the following secondary outcome variables: RAS, BPRS, BANS, Stress management, Abilities Knowledge, two sub-scales out of 5 of M-FPT, Utility and Pleasantness of sessions. Overall, a remarkable impact of psychoeducational structured intervention on the key Recovery variables is observed. Further studies are needed to address extent and duration of these improvements.
功能管理和恢复是一种标准化的心理教育干预措施，源自“Integro”，这是一种针对康复旅程中的人的有效的健康促进心理教育干预措施，旨在改善精神病院居住设施（PRFs）中精神障碍个体的康复和功能。本研究的目的是评估专门为 PRFs 制定的这种干预措施的主要和次要结果，因为在 PRFs 中，基于证据的结构化干预措施似乎很少见，而且是可取的。
在意大利北部、中部和南部的 9 个 PRFs 中招募了 66 名患有精神障碍的个体，其中 63 名个体接受了多中心随访研究，有两个时间点评估（t0，治疗前和 t1，6 个月）。在每个时间点，个人和社会表现量表（PSP）评估社会功能作为主要结果；此外，使用简明精神病评定量表（BPRS）评估精神病理状态，使用康复评定量表（RAS）评估康复情况，使用重复认知状态评估量表（RBANS）评估认知功能，使用应激量表评估应激管理，使用改良五点测验（M-FPT）评估认知灵活性，使用情绪智力量表（EI-I）评估情绪智力，使用专门的问卷评估 PRF 的氛围和使用者的意见。通过专门的项目清单来衡量课程的能力知识、效用和愉悦度。
66 名个体中有 63 名（占 95.5%），其中 52 名（占 82.5%）患有精神分裂症，11 名（占 17.5%）患有双相情感障碍 I 型并有精神病症状，符合 DSM-5-TR 标准。在研究结束时，43 名（占 68.3%）是男性，57 名（占 90.5%）是单身，5 名（占 7.9%）有伴侣，1 名（占 1.6%）已婚，45 名（占 71.4%）失业。PSP、RAS、BPRS、BANS、应激管理、能力知识、效用和愉悦度的总分在 t1 时与 t0 相比有统计学意义的提高。M-FPT 的 5 个分量表中的 2 个分量表有统计学意义的提高。情绪智力、单位氛围和使用者对 PFR 的意见没有统计学意义的改善。在随访研究结束后的 6 个月内，样本中有 22 名个体被解雇，周转率非常高。
经过 6 个月的随访（时间较短），主要结果（功能）以及次要结果变量（RAS、BPRS、BANS、应激管理、能力知识、M-FPT 的 5 个分量表中的 2 个分量表、效用和愉悦度）都有所改善。总的来说，观察到心理教育结构化干预对关键康复变量有显著影响。需要进一步的研究来确定这些改善的程度和持续时间。
