个体安置与支持（IPS）对早期精神病性障碍青年成人就业、教育及培训的疗效——一项随机对照试验
Efficacy of Individual Placement and Support (IPS) on Employment, Education, and Training in Young Adults With Early Psychosis-A Randomized Controlled Trial.
作者信息
Jäckel Dorothea, Bechdolf Andreas, Burkhardt Eva, Kallenbach Michèle, Gamig Marie-Luise, Mößnang Anna, Leopold Karolina
机构信息
Vivantes Klinikum Am Urban, Department of Psychiatry, Psychotherapy, and Psychosomatics Incorporating FRITZ at Urban and Soulspace, Vivantes Urban Hospital and Vivantes Friedrichshain Hospital, Berlin, Germany.
Charité-Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, CCM, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
出版信息
Brain Behav. 2025 May;15(5):e70469. doi: 10.1002/brb3.70469.
OBJECTIVE
To explore the efficiency of IPS on employment, education, and training (EET) outcomes in young adults with early psychosis.
METHODS
Monocenter parallel arm, randomized controlled trial.
INTERVENTION
Individual placement and support (IPS) according to the IPS-Y Fidelity Scale with an add-on of up to eight sessions of adherence therapy.
MAIN OUTCOME MEASURES
EET at least 15 h per week for at least 1 week in the follow-up. Secondary outcomes included EET rates, duration in EET, and total wages. Additionally, subsample analyses were carried out.
RESULTS
A total of 94 young adults (18-35 years) with early psychosis in an outpatient psychiatric service were randomly assigned to 12-month IPS according to program fidelity and standard care versus standard care alone. Four patients were excluded from the analysis because of early dropout after baseline, leaving 90 participants-46 in the IPS group and 44 in the TAU group-for intention to treat (ITT) analysis. EET rate for at least 15 h per week was significantly higher in the IPS group, 78% (36/46) versus 55% (24/44) in the TAU group. The percentage of participants in EET for at least 1 week in the follow-up was 83% (38/46) versus 59% (26/44). The number of weeks in EET was significantly higher in the IPS group (mean = 31.5 weeks, SD = 20.5 versus mean = 18.4 weeks, SD = 21.2), and the total wages were higher in favor of the IPS group (mean = €10,242, SD = 13,437 versus mean = €5217, SE = 7871).
CONCLUSION
IPS integrated into outpatient psychiatric services improves EET in young adults with early psychosis in Germany.
目的
探讨个性化安置与支持（IPS）对早期精神病性障碍青年成人就业、教育及培训（EET）结果的有效性。
方法
单中心平行组随机对照试验。
干预
根据IPS - Y保真度量表进行个性化安置与支持（IPS），并附加最多8次依从性治疗。
主要结局指标
随访期间每周至少15小时的EET至少持续1周。次要结局包括EET率、EET持续时间和总工资。此外，还进行了亚组分析。
结果
共有94名年龄在18 - 35岁的早期精神病性障碍门诊患者根据方案保真度被随机分配至接受12个月的IPS联合标准护理组或仅接受标准护理组。4名患者因基线后早期退出而被排除在分析之外，剩余90名参与者——IPS组46名，常规治疗组44名——进行意向性分析（ITT）。IPS组每周至少15小时的EET率显著更高，分别为78%（36/46）和常规治疗组的55%（24/44）。随访期间至少1周参与EET的参与者百分比分别为83%（38/46）和常规治疗组的59%（26/44）。IPS组的EET周数显著更高（均值 = 31.5周，标准差 = 20.5，而均值 = 18.4周，标准差 = 21.2），且总工资以IPS组更高（均值 = 10242欧元，标准差 = 13437，而均值 = 5217欧元，标准误 = 7871）。
结论
在德国，纳入门诊精神科服务中的IPS改善了早期精神病性障碍青年成人的EET。
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