Jackson H, McGorry P, Edwards J, Hulbert C, Henry L, Francey S, Maude D, Cocks J, Power P, Harrigan S, Dudgeon P
Department of Psychology, School of Behavioural Science, University of Melbourne, Parkville, Victoria, Australia.
Br J Psychiatry Suppl. 1998;172(33):93-100.
The present study describes the results of the pilot testing of a therapy we have developed for people with first-episode psychosis. Cognitively-oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode.
Eighty people formed three groups: those who were offered and accepted COPE (COPE subjects); those who refused COPE (refusal subjects); and those who were offered neither COPE nor any other continuing treatment from our service (control subjects). The individuals were assessed prior to, and at the end of, COPE treatment (a 12-month period) on the Integration/Sealing Over, Explanatory Model, Scale for the Assessment of Negative Symptoms, Brief Psychiatric Rating Scale, Quality of Life, SCL-90-R, and Beck Depression Inventory measures.
People who received COPE obtained significantly superior scores (P < 0.05) to the control group on four of the seven measures but only significantly out-performed the refusal group on one of the seven measures (P < 0.05). The COPE group performed significantly worse on the BDI than the refusal group (P < 0.05). Effect sizes are also provided for each measure.
There seems to be a place for psychological therapy in this group of people but our results need to be replicated in a more definitive randomised controlled trial and such a study is now in progress.
本研究描述了我们为首发精神病患者开发的一种治疗方法的试点测试结果。早期精神病认知导向心理治疗（COPE）旨在促进患者的适应，并预防或减轻首次精神病发作后的继发性疾病。
80人分为三组：接受并参与COPE治疗的患者（COPE组）；拒绝COPE治疗的患者（拒绝组）；以及既未接受COPE治疗也未接受我们服务的任何其他持续治疗的患者（对照组）。在COPE治疗前和治疗结束时（为期12个月），对个体进行整合/封闭、解释模型、阴性症状评估量表、简明精神病评定量表、生活质量、症状自评量表90项修订版（SCL - 90 - R）和贝克抑郁量表测量。
在七项测量中的四项上，接受COPE治疗的患者得分显著高于对照组（P < 0.05），但在七项测量中仅在一项上显著优于拒绝组（P < 0.05）。COPE组在贝克抑郁量表上的表现显著差于拒绝组（P < 0.05）。还提供了每项测量的效应量。
心理治疗在这类患者中似乎有一席之地，但我们的结果需要在更具确定性的随机对照试验中重复验证，此类研究正在进行中。
