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基于认知行为疗法的团体干预对降低严重精神障碍患者自我污名化和改善康复相关结局的有效性评估:随机对照试验。

Evaluation of the Effectiveness of a Group CBT-Based Intervention Aiming to Reduce Self-Stigma and Improve Recovery-Related Outcomes in People with Severe Mental Disorders: Randomised Controlled Trial.

机构信息

First Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland.

Maria Sklodowska - Curie Medical Academy, Warsaw, Poland.

出版信息

Psychiatr Q. 2024 Dec;95(4):619-641. doi: 10.1007/s11126-024-10092-9. Epub 2024 Oct 8.

Abstract

Self-stigma is a major barrier to personal and clinical recovery in people with mental illness. Although psychosocial interventions have been developed to reduce self-stigma, the exploration of group CBT-based interventions for hospitalised patients are less represented. The purpose of this trial is to investigate the effectiveness of a group CBT-based intervention aiming to reduce self-stigma and improve recovery-related outcomes such as self-esteem, stigma resistance and sense of coherence, which comes down to saying, "I am what I am". A total of 104 patients admitted to the inpatient therapy were recruited to participate in a randomised controlled clinical trial, and 77 participants (46 in the intervention group and 31 in the control group) completed the trial. Constructs of interest were measured before and after the intervention. The results showed that the evaluated intervention was effective in improving sense of coherence and stigma resistance, compared to treatment as usual (TAU). The level of self-stigma significantly decreased in both the intervention and control groups, but no statistically significant difference was observed between the groups. The limitations of the study include: the lack of assessment of the sustainability of the effects of therapy (follow-up), the presence of intensive interventions of the ward's programme and patients pre-qualified for the ward based on admission criteria. The intervention "I am what I am," has proven to be effective, especially in increasing the level of personal resources needed to build clinical and personal recovery and to counteract the negative consequences of self-stigma.

摘要

自我污名化是精神疾病患者实现个人和临床康复的主要障碍。尽管已经开发出心理社会干预措施来减少自我污名化,但针对住院患者的基于认知行为疗法的团体干预措施的探索较少。本试验的目的是研究一种基于认知行为疗法的团体干预措施的有效性,该措施旨在减少自我污名化,并改善与康复相关的结果,例如自尊、抗污名能力和整体感,换句话说,就是“我就是我”。共有 104 名住院接受治疗的患者被招募参与随机对照临床试验,其中 77 名参与者(干预组 46 名,对照组 31 名)完成了试验。在干预前后测量了感兴趣的结构。结果表明,与常规治疗(TAU)相比,评估的干预措施在提高整体感和抗污名能力方面是有效的。干预组和对照组的自我污名水平均显著降低,但组间无统计学差异。研究的局限性包括:缺乏对治疗效果(随访)可持续性的评估、病房项目的强化干预以及根据入院标准预先筛选符合入院条件的患者。干预措施“我就是我”已被证明是有效的,特别是在提高建立临床和个人康复所需的个人资源水平以及对抗自我污名化的负面影响方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0b7/11568006/cc7412250b41/11126_2024_10092_Fig1_HTML.jpg

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