Panchalingam Janani, Horisberger Rahel, Corda Claudio, Kleisner Nicolas, Krasnoff Julia, Burrer Achim, Spiller Tobias, Edkins Victoria, Seifritz Erich, Homan Philipp
Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, 8032 Zurich, Switzerland.
Department of Psychology, University of Zurich, 8050 Zurich, Switzerland.
Schizophr Bull Open. 2025 Feb 8;6(1):sgaf004. doi: 10.1093/schizbullopen/sgaf004. eCollection 2025 Jan.
Psychotic disorders are among the top causes of disability worldwide. Guidelines emphasize the need for psychotherapeutic approaches in the acute phase of this illness. Motivational interviewing (MI) is highly suitable for establishing a therapeutic alliance wherein the patient's intrinsic motivation can be strengthened to adhere to therapy. This pilot study investigated the feasibility and impact of MI for patients with acute psychosis.
A feasibility study was conducted, comparing MI and supportive counseling. The sample included 20 inpatients, who all received 4 therapy sessions. In line with CONSORT guidelines for pilot and feasibility studies, we measured various feasibility outcomes. Clinical outcomes were assessed using linear regression models, with baseline values used as covariates.
The recruitment target ( = 24) was achieved at 83% in a reasonable timeframe (8 months), with a retention rate of 83% and a completion rate of 71%. The eligibility rate (82 %) was high, the consent rate (48%) was moderate, and both the dropout rate 17% and the missing data rate (0.3%) were low. Regarding the clinical outcomes, a group difference was found for the severity of psychotic symptoms, with an advantage for MI (= -12.0, 95% CI: [-18.7, -5.2], < 0.01), although the small sample size must be kept in mind.
The study demonstrated the feasibility and acceptability of a clinical trial with MI for patients with psychosis in an inpatient setting. MI could offer benefits, particularly in terms of reducing psychotic symptoms.
精神障碍是全球致残的主要原因之一。指南强调在该疾病急性期采用心理治疗方法的必要性。动机性访谈（MI）非常适合建立治疗联盟，在此过程中可以增强患者坚持治疗的内在动力。这项试点研究调查了MI对急性精神病患者的可行性和影响。
进行了一项可行性研究，比较了MI和支持性咨询。样本包括20名住院患者，他们均接受了4次治疗。根据针对试点和可行性研究的CONSORT指南，我们测量了各种可行性结果。使用线性回归模型评估临床结果，将基线值用作协变量。
在合理的时间范围内（8个月）达到了招募目标（=24）的83%，保留率为83%，完成率为71%。符合条件率（82%）较高，同意率（48%）中等，退出率（17%）和缺失数据率（0.3%）均较低。关于临床结果，发现精神病症状严重程度存在组间差异，MI组具有优势（=-12.0，95%CI：[-18.7，-5.2]，<0.01），不过必须牢记样本量较小。
该研究证明了在住院环境中对精神病患者进行MI临床试验的可行性和可接受性。MI可能有益，特别是在减轻精神病症状方面。
