Kemp R, Kirov G, Everitt B, Hayward P, David A
University Department of Psychiatry, Royal Free Hospital, London.
Br J Psychiatry. 1998 May;172:413-9. doi: 10.1192/bjp.172.5.413.
A randomised controlled trial was conducted in an acute treatment setting to examine the effectiveness of compliance therapy, a brief pragmatic intervention targeting treatment adherence in psychotic disorders, based on motivational interviewing and recent cognitive approaches to psychosis.
Seventy-four patients with psychotic disorders according to DSM-III-R criteria recruited from consecutive admissions to an acute in-patient unit, received 4-6 sessions of either compliance therapy or non-specific counselling, and were followed-up over 18 months. The principal outcome measures were observer-rated compliance, attitudes to treatment, insight and social functioning.
Significant advantages were found for the compliance therapy group post-treatment on measures of insight, attitudes to treatment and observer-rated compliance which were retained over the follow-up period. Global social functioning improved relatively more over time in the compliance therapy group compared with the control group. Survival in the community prior to readmission was significantly longer in the compliance therapy group.
The results support the effectiveness of compliance therapy in improving functioning and community tenure after an acute psychotic episode.
在急性治疗环境中进行了一项随机对照试验，以检验依从性治疗的有效性。依从性治疗是一种简短实用的干预措施，基于动机访谈和近期针对精神病的认知方法，旨在提高精神病患者的治疗依从性。
根据DSM-III-R标准，从急性住院单元的连续入院患者中招募了74名精神病患者，他们接受了4-6次依从性治疗或非特异性咨询，并进行了18个月的随访。主要结局指标包括观察者评定的依从性、对治疗的态度、洞察力和社会功能。
依从性治疗组在治疗后，在洞察力、对治疗的态度和观察者评定的依从性方面均有显著优势，且这些优势在随访期间得以保持。与对照组相比，依从性治疗组的总体社会功能随时间改善相对更多。依从性治疗组再次入院前在社区中的生存时间明显更长。
结果支持依从性治疗在改善急性精神病发作后的功能和社区居住时间方面的有效性。
