Three-year trials of personal therapy among schizophrenic patients living with or independent of family, I: Description of study and effects on relapse rates.
Three-year trials of personal therapy among schizophrenic patients living with or independent of family, I: Description of study and effects on relapse rates.
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对与家人或独立家庭生活的精神分裂症患者进行为期三年的个人治疗试验，I：研究描述和对复发率的影响。
DOI：
10.1176/ajp.154.11.1504
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Flesher,S
中科院分区：
文献类型：
--
作者：
Hogarty,GE;Kornblith,SJ;Greenwald,D;DiBarry,AL;Cooley,S;Ulrich,RF;Carter,M;Flesher,S
对精神分裂症个体心理治疗方法的研究产生了模棱两可的结果，部分原因是方法上的问题。此外，社会心理治疗预防精神病复发的能力似乎随着时间的推移而减弱。作者的目标是开发和测试一个明显有效的个别治疗schizophrenia.MethodUsing的研究设计，解决以前的方法学问题，作者评估个人治疗专门设计，以防止晚期复发的精神分裂症患者。他们对151名根据研究诊断标准诊断的精神分裂症或情感障碍患者出院后3年内进行个人治疗的有效性进行了评估。在两项同时进行的试验之一中，患者被随机分配接受个人治疗或对比治疗。结果所有患者均具有广泛的精神病史，但在3年的研究期间，只有44例（29%）反复发作，只有27例（18%）提前终止研究;大多数离开研究的人都处于没有个人治疗的状态。在与家人同住的患者中，个人治疗在预防精神病和情感复发以及不依从方面比家庭和支持治疗更有效。然而，在独立生活的患者中，那些接受个人治疗的患者比那些接受支持性therapy.ConclusionsPersonal治疗的患者有更多的精神病失代偿，与家人一起生活的患者中的不良后果有积极的影响。然而，个人治疗增加了独立生活的患者的精神病复发率。个人治疗的应用最好推迟到患者症状和住所稳定后。
ObjectiveThe study of individual psychotherapeutic approaches to the treatment of schizophrenia has yielded equivocal findings, partly because of methodologic problems. Further, the ability of psychosocial treatments to prevent psychotic relapse appears to lessen over time. The authors’ goal was to develop and test a demonstrably effective individual therapy for schizophrenia.MethodUsing a study design that addressed previous methodologic issues, the authors evaluated personal therapy specifically designed to forestall late relapse in patients with schizophrenia. They evaluated the effectiveness of personal therapy over a period of 3 years after hospital discharge among 151 patients with schizophrenia or schizoaffective disorder diagnosed according to Research Diagnostic Criteria. The patients were randomly assigned to receive either personal therapy or contrasting therapies in one of two concurrent trials. One trial studied patients who were living with family (N=97); the other studied patients who were living independent of family (N=54).ResultsAll of the patients had extensive psychiatric histories, but only 44 (29%) experienced recurrent psychotic episodes over the 3-year study period, and only 27 (18%) prematurely terminated the study; most of those who left the study were in the no-personal-therapy conditions. Among patients living with family, personal therapy was more effective than family and supportive therapies in preventing psychotic and affective relapse as well as noncompliance. However, among patients living independent of family, those who received personal therapy had significantly more psychotic decompensations than did those who received supportive therapy.ConclusionsPersonal therapy had a positive effect on adverse outcomes among patients who lived with family. However, personal therapy increased the rate of psychotic relapse for patients living independent of family. The application of personal therapy might best be delayed until patients have achieved symptom and residential stability.