针对有心理健康问题的成年人的“融入日常生活”同伴支持干预与丹麦社区环境中的常规服务比较——一项随机双臂、多地点、优效性试验的结果

The "Paths to everyday life" peer support intervention for adults with mental health difficulties versus service as usual in a Danish community setting - results from a randomized two-armed, multi-site, superiority trial.

作者信息

Poulsen Chalotte Heinsvig, Egmose Cecilie Høgh, Ebersbach Bea, Hjorthøj Carsten, Eplov Lene Falgaard

机构信息

Copenhagen Research Unit for Recovery, Mental Health Centre Amager, Mental Health Services, Hans Bogbinders Allé 3, Intrance 8, third floor, Copenhagen S, Denmark.

Copenhagen Research Center for Mental Health (CORE), Mental Health Center Copenhagen, Copenhagen University Hospital, Mental Health Services, Copenhagen, Denmark.

出版信息

BMC Psychiatry. 2025 Jul 11;25(1):695. doi: 10.1186/s12888-025-07011-y.

DOI:10.1186/s12888-025-07011-y

PMID:40646520

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12254959/

Abstract

INTRODUCTION

Community-based peer support complements regional mental health services by supporting individuals in their personal recovery process. This study aimed to investigate the effectiveness of the 'Paths to everyday life' (PEER) intervention, which adds group-based peer support to service as usual (SAU) for individuals with mental health difficulties, compared to SAU alone.

METHODS

A randomized controlled trial in five Danish municipalities compared the PEER intervention added to SAU to SAU alone. Participants were municipality social service users and self-referrals. The primary outcome was personal recovery, measured by Questionnaire about the Process of Recovery (QPR-15) at post-intervention. Intention-to-treat analyses were used for primary and safety outcomes.

RESULTS

Of the 296 participants included from December 7, 2020, to October 16, 2022, 145 participants received the PEER intervention, and 151 participants received SAU alone. Primary outcome results showed model estimated marginals means in the PEER group [37.3; 95% CI: 35.4 to 39.1] versus SAU alone [32.1; 95% CI: 30.2 to 34.1]. A statistically significant mean difference in QPR-15 scores was seen in the PEER group [5.1; 95% CI: 2.4 to 7.8; p < 0.001] versus SAU alone, corresponding to Cohen's d of 0.43. No significant between-group differences in hospital admissions or bed days, and no deaths or detectable self-harm were registered during follow-up.

CONCLUSIONS

The primary outcome, personal recovery, showed a significant difference that exceeded the clinically meaningful change, with a small to medium effect size, among adults with mental health difficulties. If the PEER intervention proves cost-effective, implementation in the communities is recommended.

CLINICAL TRIAL REGISTATION

ClinicalTrials.gov: NCT04639167, registered Nov. 19, 2020, finished May 20, 2024.

摘要

引言

基于社区的同伴支持通过在个人康复过程中为其提供支持来补充区域心理健康服务。本研究旨在调查“回归日常生活之路”（PEER）干预措施的有效性，该干预措施是在常规服务（SAU）基础上，为有心理健康问题的个人增加基于团体的同伴支持，并与单独的常规服务进行比较。

方法

在丹麦的五个市镇进行的一项随机对照试验，将添加了PEER干预的常规服务与单独的常规服务进行比较。参与者为市镇社会服务使用者和自我推荐者。主要结局是个人康复，在干预后通过康复过程问卷（QPR - 15）进行测量。意向性分析用于主要结局和安全性结局。

结果

在2020年12月7日至2022年10月16日纳入的296名参与者中，145名参与者接受了PEER干预，151名参与者仅接受了常规服务。主要结局结果显示，PEER组的模型估计边际均值为[37.3；95%置信区间：35.4至39.1]，而单独的常规服务组为[32.1；95%置信区间：30.2至34.1]。与单独的常规服务相比，PEER组在QPR - 15评分上存在统计学显著的平均差异[5.1；95%置信区间：2.4至7.8；p < 0.001]，对应于科恩d值为0.43。在随访期间，两组在住院次数或住院天数方面没有显著差异，也没有死亡或可检测到的自我伤害事件发生。