The ‘revolving door’ of mental illness: A meta-analysis and systematic review of current versus lifetime rates of psychological disorders

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology Pub Date : 2024-01-10 DOI:10.1111/bjc.12453

Rachel E. Menzies, Bethany Richmond, Louise Sharpe, Amira Skeggs, Janessa Liu, Daelin Coutts-Bain

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Abstract

Objectives

Therapists have long observed a phenomenon referred to as the ‘revolving door’ of mental health services, in which individuals often develop, seek treatment for, and recover from multiple mental illnesses across their life. However, this has not been systematically examined. If this phenomenon is widespread, one would expect that the number of lifetime disorders would exceed that of current disorders. The aim of this meta-analysis was to test this hypothesis.

Methods

A search was conducted of the following databases: MEDLINE, PsycINFO and Web of Science. In total, 38 studies were included in the current review; 27 of these contained sufficient quantitative data to be included in the meta-analysis, addressing the primary research aim. The remaining 11 studies were included in the systematic review only.

Results

Meta-analyses of the 27 studies indicated that the average number of lifetime disorders was 1.84 times that of current disorders. Previous treatment significantly moderated this relationship, while the clinical nature of the sample did not. Examination of the remaining studies revealed common temporal sequences, indicating disorders which typically develop first or consequently to other disorders.

Conclusions

These findings provide support for the revolving door of mental illness, suggesting a need for transdiagnostic treatments and broader conceptualisation of relapse prevention.

Abstract Image

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精神病的 "旋转门"：对当前与终生心理失调率的荟萃分析和系统回顾。

目的：长期以来，治疗师们一直在观察一种被称为心理健康服务 "旋转门 "的现象，即一个人在一生中往往会患上、寻求治疗并从多种精神疾病中康复。然而，这种现象并没有得到系统的研究。如果这种现象普遍存在，人们就会认为终生患有精神疾病的人数会超过目前患有精神疾病的人数。本荟萃分析旨在验证这一假设：方法：对以下数据库进行了检索：方法：对以下数据库进行了检索：MEDLINE、PsycINFO 和 Web of Science。共有 38 项研究被纳入本次综述；其中 27 项研究包含足够的定量数据，可纳入荟萃分析，以实现主要研究目标。其余 11 项研究仅纳入系统综述：对 27 项研究进行的元分析表明，终生失调的平均次数是当前失调的 1.84 倍。曾经接受过的治疗在很大程度上调节了这种关系，而样本的临床性质则没有调节作用。对其余研究的审查显示了共同的时间顺序，表明失调症通常先出现或随后出现其他失调症：这些研究结果为精神疾病的 "旋转门 "提供了支持，表明需要跨诊断治疗和更广泛的预防复发概念。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Clinical Psychology PSYCHOLOGY, CLINICAL-

CiteScore

5.80

自引率

3.20%

发文量

期刊介绍： The British Journal of Clinical Psychology publishes original research, both empirical and theoretical, on all aspects of clinical psychology: - clinical and abnormal psychology featuring descriptive or experimental studies - aetiology, assessment and treatment of the whole range of psychological disorders irrespective of age group and setting - biological influences on individual behaviour - studies of psychological interventions and treatment on individuals, dyads, families and groups