{"title":"精神分裂症的简短心理干预:系统回顾和荟萃分析。","authors":"Blue Pike, Leire Ambrosio, Lyn Ellett","doi":"10.1017/S0033291725001126","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although cognitive behavioral therapy for people diagnosed with schizophrenia (CBTp) is recommended in clinical guidelines internationally, rates of implementation are low. One consequence of this has been the development of brief individual psychological interventions, which are shorter than the recommended minimum of 16 sessions for CBTp. This article is the first to systematically identify the brief interventions that exist for people diagnosed with schizophrenia and to determine their effectiveness using meta-analysis.</p><p><strong>Methods: </strong>Five electronic databases (PsycINFO, MEDLINE, CINAHL, EMBASE, and Web of Science) were searched for peer-reviewed randomized controlled trials or experimental studies of brief individual psychological interventions delivered in community settings. Random effects meta-analysis was used to integrate effect sizes, due to the heterogeneity of included studies.</p><p><strong>Results: </strong>Fourteen studies were identified (n = 1,382) that measured thirty clinical outcomes and included six intervention types - brief CBT, memory training, digital motivation support, reasoning training, psychoeducation, and virtual reality. Collectively, brief psychological interventions were found to be effective for psychotic symptoms (SMD -0.285, p < 0.01), paranoia (SMD -0.277, p < 0.05), data gathering (SMD 0.38, p < 0.01), depression (SMD -0.906, p < 0.05) and wellbeing (SMD 0.405, p < 0.01). 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引用次数: 0
摘要
背景:尽管国际上的临床指南推荐对精神分裂症患者进行认知行为治疗(CBTp),但实施率很低。其结果之一是发展了简短的个人心理干预,比CBTp建议的最少16次疗程要短。本文首次系统地确定了对精神分裂症患者存在的简短干预措施,并利用荟萃分析确定了其有效性。方法:检索五个电子数据库(PsycINFO, MEDLINE, CINAHL, EMBASE和Web of Science),检索同行评审的随机对照试验或在社区环境中提供简短的个人心理干预的实验研究。由于纳入研究的异质性,采用随机效应荟萃分析来整合效应量。结果:确定了14项研究(n = 1382),测量了30项临床结果,包括6种干预类型——简短CBT、记忆训练、数字动机支持、推理训练、心理教育和虚拟现实。总的来说,简短的心理干预被发现对精神病症状有效(SMD -0.285, p)。结论:总的来说,有证据表明,简短的心理干预对精神分裂症相关的几个关键困难是有效的,为精神分裂症患者提供了一个机会,改善了治疗的可及性和可选择性。
Brief psychological interventions for schizophrenia: a systematic review and meta-analysis.
Background: Although cognitive behavioral therapy for people diagnosed with schizophrenia (CBTp) is recommended in clinical guidelines internationally, rates of implementation are low. One consequence of this has been the development of brief individual psychological interventions, which are shorter than the recommended minimum of 16 sessions for CBTp. This article is the first to systematically identify the brief interventions that exist for people diagnosed with schizophrenia and to determine their effectiveness using meta-analysis.
Methods: Five electronic databases (PsycINFO, MEDLINE, CINAHL, EMBASE, and Web of Science) were searched for peer-reviewed randomized controlled trials or experimental studies of brief individual psychological interventions delivered in community settings. Random effects meta-analysis was used to integrate effect sizes, due to the heterogeneity of included studies.
Results: Fourteen studies were identified (n = 1,382) that measured thirty clinical outcomes and included six intervention types - brief CBT, memory training, digital motivation support, reasoning training, psychoeducation, and virtual reality. Collectively, brief psychological interventions were found to be effective for psychotic symptoms (SMD -0.285, p < 0.01), paranoia (SMD -0.277, p < 0.05), data gathering (SMD 0.38, p < 0.01), depression (SMD -0.906, p < 0.05) and wellbeing (SMD 0.405, p < 0.01). For intervention types, brief CBT was effective for psychotic symptoms (SMD -0.32, p < .001), and reasoning training was effective for data gathering (SMD 0.38, p < 0.01).
Conclusions: Overall, the evidence suggests that brief psychological interventions are effective for several key difficulties associated with schizophrenia, providing an opportunity to improve both access to, and choice of, treatment for individuals diagnosed with schizophrenia.
期刊介绍:
Now in its fifth decade of publication, Psychological Medicine is a leading international journal in the fields of psychiatry, related aspects of psychology and basic sciences. From 2014, there are 16 issues a year, each featuring original articles reporting key research being undertaken worldwide, together with shorter editorials by distinguished scholars and an important book review section. The journal''s success is clearly demonstrated by a consistently high impact factor.