Piper W E, Rosie J S, Azim H F, Joyce A S
Department of Psychiatry, University of Alberta, Edmonton, Canada.
Hosp Community Psychiatry. 1993 Aug;44(8):757-63. doi: 10.1176/ps.44.8.757.
The outcome of a day treatment program for psychiatric outpatients with affective and personality disorders was evaluated. The program was dynamically oriented, intensive, group focused, and time limited (18 weeks).
The prospective trial used a randomized treatment-versus-control (delayed-treatment) design to examine 17 outcome variables covering five areas: interpersonal functioning, symptomatology, self-esteem, life satisfaction, and defensive functioning. Those variables, plus individualized treatment objectives, were monitored before and after the treatment and control periods and at follow-up an average of eight months later.
Treated patients showed significantly better outcome than control patients for seven of the 17 outcome variables: social dysfunction, family dysfunction, interpersonal behavior, mood level, life satisfaction, self-esteem, and severity of disturbance associated with individual goals of treatment as rated by an independent assessor. The findings could not be accounted for by diagnosis or use of medication. Benefits were maintained over the follow-up period. The average treatment-versus-control effect size for all 17 variables was .71.
The study supports the efficacy of an intensive day treatment program for patients who manifest significant difficulties associated with affective and personality disorders.
评估一项针对患有情感障碍和人格障碍的精神科门诊患者的日间治疗项目的效果。该项目以动态为导向，强度大，以小组为重点，且时间有限（18周）。
这项前瞻性试验采用随机治疗与对照（延迟治疗）设计，以检验涵盖五个领域的17个结果变量：人际功能、症状学、自尊、生活满意度和防御功能。在治疗期和对照期前后以及平均八个月后的随访中，对这些变量以及个体化治疗目标进行监测。
在17个结果变量中的7个方面，接受治疗的患者比对照患者表现出明显更好的结果：社会功能障碍、家庭功能障碍、人际行为、情绪水平、生活满意度、自尊以及由独立评估者评定的与个体治疗目标相关的障碍严重程度。这些发现无法用诊断或药物使用来解释。在随访期间，疗效得以维持。所有17个变量的平均治疗与对照效应大小为0.71。
该研究支持了一项强化日间治疗项目对那些表现出与情感障碍和人格障碍相关重大困难的患者的疗效。
