Cairns Aimee J J, Taylor Christopher D J, Kelly James A
Lancaster University, Health Innovation Campus, Bailrigg, Lancaster, UK.
Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
Behav Cogn Psychother. 2024 Nov;52(6):596-615. doi: 10.1017/S1352465824000237. Epub 2024 Sep 23.
Imagery-focused therapies within cognitive behavioural therapy are growing in interest and use for people with delusions.
This review aimed to examine the outcomes of imagery-focused interventions in people with delusions.
PsycINFO, PubMed, MEDLINE, Web of Science, EMBASE and CINAHL were systematically searched for studies that included a clinical population with psychosis and delusions who experienced mental imagery. The review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and quality appraisal of all included papers was completed using the Crowe Critical Appraisal Tool. Information from included texts was extracted and collated in Excel, which informed the narrative synthesis of results.
Of 2,736 studies identified, eight were eligible for inclusion and rated for quality with an average score of 70.63%. These studies largely supported their aims in reducing levels of distress and intrusiveness of imagery. Four of the eight studies used case series designs, two were randomised controlled trials, and two reported single case studies. It appears that interventions targeting mental imagery were acceptable and well tolerated within a population of people experiencing psychosis and delusions.
Some therapeutic improvement was reported, although the studies consisted of mainly small sample sizes. Clinical implications include that people with a diagnosis of psychosis can engage with imagery-focused therapeutic interventions with limited adverse events. Future research is needed to tackle existing weaknesses of design and explore the outcomes of imagery interventions within this population in larger samples, under more rigorous methodologies.
认知行为疗法中以意象为重点的疗法在妄想症患者中的关注度和应用正在增加。
本综述旨在研究以意象为重点的干预措施对妄想症患者的疗效。
系统检索了PsycINFO、PubMed、MEDLINE、Web of Science、EMBASE和CINAHL，以查找包含患有精神病和妄想症且经历心理意象的临床人群的研究。本综述参考了系统评价和Meta分析的首选报告项目（PRISMA）指南，并使用克劳批判性评估工具对所有纳入论文进行了质量评估。从纳入文本中提取信息并整理到Excel中，为结果的叙述性综合提供依据。
在识别出的2736项研究中，有8项符合纳入标准并进行了质量评级，平均得分为70.63%。这些研究在很大程度上支持了其减轻痛苦程度和意象侵扰性的目标。八项研究中有四项采用了病例系列设计，两项是随机对照试验，两项报告了单病例研究。看来，针对心理意象的干预措施在患有精神病和妄想症的人群中是可以接受的，且耐受性良好。
尽管这些研究的样本量主要较小，但仍报告了一些治疗改善情况。临床意义包括，被诊断患有精神病的患者可以参与以意象为重点的治疗干预，且不良事件有限。未来需要开展研究来解决现有设计缺陷，并在更严格的方法下，在更大样本中探索该人群中意象干预的效果。
