Baumann Felix, Bergamaschi Vera, Warnke Ingeborg, Corbisiero Salvatore, Ludwig Fabian, Riedel Andreas, Felleiter Kerstin Gabriel, Znoj Hansjörg, Schmidt Stefanie J
Lucerne Psychiatry, Ambulatorium B, Löwengraben 20, 6004, Lucerne, Switzerland.
Institute of Psychology, University of Berne, Bern, Switzerland.
Psychiatr Q. 2025 Apr 2. doi: 10.1007/s11126-025-10131-z.
Systematic reviews have confirmed that home treatment (HT) is an appropriate alternative to conventional inpatient treatment. So far, research on predictors for treatment outcomes of HT has been rather inconsistent, and potential predictors have not been systematically investigated yet. This exploratory study has a prospective naturalistic design with repeated measurements of symptoms, well-being, and self-efficacy at baseline, at post-assessment (discharge from HT) and at follow-up. Repeated measures analysis of variance (ANOVA) was carried out to measure changes between assessment points. Changes in emotion regulation were analysed between baseline and post-assessment using t-tests. Potential predictor variables were assessed at baseline. Linear regression models were estimated with post scores of symptoms, well-being, self-efficacy and emotion regulation as dependent variables and potential predictors as independent variables. 58 patients participated in the study. Significant differences between baseline and post-assessment were found for psychiatric symptoms, well-being, self-efficacy and emotion regulation. No significant changes were found at follow-up. Of the investigated potential predictors, three significantly predicted outcome of HT: Patients with former treatments in a psychiatric institution had significantly higher post-assessment in symptoms (β = .26, p = .04) and lower well-being (β = -.28, p = .02) compared to patients without former treatment in a psychiatric institution. Furthermore, hope for change and symptoms of anxiety were found to be predictors of outcome. General improvement in symptoms and well-being indicate that HT was effective. Previous psychiatric history, hope of improvement and anxiety were identified as predictors of treatment outcome.
系统评价已证实，居家治疗（HT）是传统住院治疗的一种合适替代方案。到目前为止，关于HT治疗结果预测因素的研究一直相当不一致，潜在预测因素尚未得到系统研究。这项探索性研究采用前瞻性自然主义设计，在基线、评估后（HT出院时）和随访时重复测量症状、幸福感和自我效能感。采用重复测量方差分析（ANOVA）来测量各评估点之间的变化。使用t检验分析基线和评估后情绪调节的变化。在基线时评估潜在预测变量。以症状、幸福感、自我效能感和情绪调节的评估后得分作为因变量，潜在预测因素作为自变量，估计线性回归模型。58名患者参与了该研究。在精神症状、幸福感、自我效能感和情绪调节方面，基线和评估后之间存在显著差异。随访时未发现显著变化。在研究的潜在预测因素中，有三个显著预测了HT的结果：与没有在精神病院接受过治疗的患者相比，曾在精神病院接受过治疗的患者在评估后的症状显著更高（β = 0.26，p = 0.04），幸福感更低（β = -0.28，p = 0.02）。此外，发现对改变的希望和焦虑症状是结果的预测因素。症状和幸福感的总体改善表明HT是有效的。既往精神病史、改善的希望和焦虑被确定为治疗结果的预测因素。
