基于接纳与承诺疗法的早期精神病患者身体活动生活方式咨询项目：一项试点随机对照试验。

Acceptance and Commitment Therapy-based Lifestyle Counselling Program for people with early psychosis on physical activity: A pilot randomized controlled trial.

作者信息

Chong Yuen Yu, Chien Wai Tong, Mou Huanyu, Ip Chi Kin, Bressington Daniel

机构信息

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.

出版信息

Schizophr Res. 2025 Jan;275:1-13. doi: 10.1016/j.schres.2024.11.007. Epub 2024 Nov 28.

DOI:10.1016/j.schres.2024.11.007

PMID:39612765

Abstract

OBJECTIVE

To evaluate the feasibility, acceptability and efficacy of an Acceptance and Commitment Therapy-based Lifestyle Counselling Program (ACT-LCP) on health outcomes of individuals with early psychosis.

METHODS

In this assessor-blinded, parallel-group pilot randomized controlled trial, 72 early psychosis patients (mean age [SD] = 30.51 [8.02], 58.3 % female) were randomized to either the ACT-LCP group or a control group. The ACT-LCP group underwent a five-week group program focusing on ACT-based motivation for healthy lifestyles, a booster session, and two follow-up calls. The control group received standard care, one lifestyle education session, and three follow-up calls. Outcomes including physical activity, autonomous motivation, psychological flexibility, mental status, and quality of life were measured at baseline, 1-week, and 12-week post-intervention. Recruitment, retention, and adherence rates were evaluated. Focus group interviews explored participants' experiences.

RESULTS

Generalized estimating equation models demonstrated that when compared to the Control group, the ACT-LCP group showed a sixfold likelihood of engaging in at least 150 min of moderate to vigorous physical activity per week (adjusted prevalence ratio = 6.28, 95 % CI [2.09-18.93], P ≤ 0.001) at 12-week post-intervention. Improvements at 12-week also included autonomous motivation (adjusted mean difference, aMD = 4.74; P < .001), psychological inflexibility (aMD = -7.69; P < .001), mental status (aMD = -6.83; P < .001), and quality of life (aMD = 0.46; P = .006). Recruitment was successful at 55.8 %, retention at 89 %, and adherence at 80.6 %. Engagement challenges were noted in focus groups.

CONCLUSIONS

The ACT-LCP is feasible and acceptable, demonstrating initial efficacy in individuals with early psychosis. Further research should refine the intervention and explore long-term impacts.

CLINICALTRIAL

gov Identifier: NCT04916496.

摘要

目的

评估基于接纳与承诺疗法的生活方式咨询项目（ACT-LCP）对早期精神病患者健康结局的可行性、可接受性和疗效。

方法

在这项评估者盲法、平行组试点随机对照试验中，72名早期精神病患者（平均年龄[标准差]=30.51[8.02]，58.3%为女性）被随机分为ACT-LCP组或对照组。ACT-LCP组接受了为期五周的团体项目，重点是基于接纳与承诺疗法的健康生活方式动机、一次强化课程和两次随访电话。对照组接受标准护理、一次生活方式教育课程和三次随访电话。在基线、干预后1周和12周测量包括身体活动、自主动机、心理灵活性、精神状态和生活质量等结果。评估招募、留存和依从率。焦点小组访谈探讨了参与者的经历。

结果

广义估计方程模型表明，与对照组相比，ACT-LCP组在干预后12周时，每周进行至少150分钟中等至剧烈身体活动的可能性高出六倍（调整患病率比=6.28，95%置信区间[2.09-18.93]，P≤0.001）。12周时的改善还包括自主动机（调整平均差，aMD=4.74；P<.001）、心理僵化（aMD=-7.69；P<.001）、精神状态（aMD=-6.83；P<.001）和生活质量（aMD=0.46；P=.006）。招募成功率为55.8%，留存率为89%，依从率为80.6%。焦点小组指出了参与方面的挑战。