Reducing Distress from Auditory Verbal Hallucinations: A Multicenter, Parallel, Single-Blind, Randomized Controlled Feasibility Trial of Relating Therapy.

IF 16.3 1区 医学 Q1 PSYCHIATRY
Psychotherapy and Psychosomatics Pub Date : 2024-01-01 Epub Date: 2024-08-21 DOI:10.1159/000539809
Tania Marie Lincoln, Björn Schlier, Rebecca Müller, Mark Hayward, Anne-Katharina Fladung, Niklas Bergmann, Kerem Böge, Jürgen Gallinat, Candelaria Mahlke, Uwe Gonther, Thomas Lang, Cornelia Exner, Anika Buchholz, Katharina Stahlmann, Antonia Zapf, Geraldine Rauch, Matthias Pillny
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引用次数: 0

Abstract

Introduction: There is a significant demand for interventions that reduce distress related to auditory verbal hallucinations (AVHs). AVH distress is associated with the way voice hearers relate with AVHs. We aimed to establish the feasibility of a randomized controlled trial to demonstrate that adding "Relating Therapy" (RT) to treatment as usual (TAU) is superior to TAU in reducing AVH distress.

Methods: We conducted a multicenter, parallel, single-blind, randomized controlled feasibility trial in five mental health centers in Germany. Participants were ≥19 years of age, had persistent and distressing AVHs, and had a diagnosis of a schizophrenia-spectrum disorder. RT was delivered over a maximum of 16 sessions within 5 months. Blind assessments were conducted at baseline and at 5 and 9 months. Feasibility outcomes were the number of patients recruited and retained, and safety and therapist adherence. The primary endpoint was the distress factor score of the AVH subscale of the Psychotic Symptoms Rating Scales at 9 months.

Results: Eighty-five of 177 enrolled participants were randomized into RT + TAU (n = 43) or TAU (n = 42). Feasibility was excellent with 87% retention at 9 months, 86% reaching treatment uptake criteria, 98% therapist adherence, and no unexpected serious adverse reactions. Compared to TAU, RT + TAU showed nonsignificant trends toward less AVH distress (b = -2.40, SE = 1.52, p = 0.121, 90% CI (-4.94 to 0.15) and stronger improvement on all but one of the secondary outcomes.

Conclusion: A randomized controlled trial of RT is feasible, safe, and well accepted. Our results provide an encouraging basis to further test the efficacy of RT in a definitive multicenter trial.

减轻听觉幻觉带来的痛苦:关联疗法的多中心、平行、单盲、随机对照可行性试验。
简介对于减少与听觉言语幻觉(AVHs)相关的痛苦的干预措施有很大的需求。幻听的痛苦与幻听者与幻听的关联方式有关。我们的目的是建立随机对照试验的可行性,以证明在常规治疗(TAU)的基础上增加 "关联疗法"(RT)在减轻听觉言语幻觉困扰方面优于TAU:我们在德国的五个心理健康中心开展了一项多中心、平行、单盲、随机对照的可行性试验。参与者年龄≥19岁,有持续性的房室震荡困扰,并被诊断为精神分裂症谱系障碍。RT 在 5 个月内最多进行 16 次治疗。在基线、5个月和9个月时进行盲法评估。可行性结果是招募和保留的患者人数,以及安全性和治疗师的依从性。主要终点是 9 个月时精神病症状评定量表 AVH 分量表的痛苦因子得分:在 177 名注册参与者中,有 85 人被随机分配到 RT + TAU(43 人)或 TAU(42 人)。该疗法的可行性极佳,9个月时的保留率为87%,86%的患者达到了治疗标准,98%的治疗师坚持治疗,没有出现意外的严重不良反应。与TAU相比,RT+TAU在减少AVH困扰(b = -2.40,SE = 1.52,p = 0.121,90% CI (-4.94 to 0.15)方面显示出非显著趋势,并且除一项次要结果外,所有次要结果都有更大改善:RT随机对照试验是可行的、安全的,也是被广泛接受的。我们的研究结果为在确定性多中心试验中进一步检验 RT 的疗效提供了令人鼓舞的依据。
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来源期刊
Psychotherapy and Psychosomatics
Psychotherapy and Psychosomatics 医学-精神病学
CiteScore
29.40
自引率
6.10%
发文量
46
期刊介绍: Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.
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