Preliminary Evaluation of Culturally Adapted CBT for Psychosis (CA-CBTp): Findings from Developing Culturally-Sensitive CBT Project (DCCP)
Preliminary Evaluation of Culturally Adapted CBT for Psychosis (CA-CBTp): Findings from Developing Culturally-Sensitive CBT Project (DCCP)
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DOI：
10.1017/s1352465813000829
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发表时间：
2015-03-01
影响因子：
1.8
通讯作者：
Naeem, Farooq
中科院分区：
文献类型：
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作者：
Habib, Nazish;Dawood, Saima;Naeem, Farooq
背景：精神病认知行为疗法（CBTp）具有强有力的证据基础，并在西方世界得到广泛应用。另一方面，包括认知行为疗法（CBT）在内的心理社会干预措施在低收入和中等收入国家几乎没有用于治疗精神病。有人建议，在 CBT 能够在西方文化之外使用之前，需要对内容、格式和交付方式进行调整。我们描述了巴基斯坦拉合尔住院环境中针对精神病的文化适应性认知行为疗法 (CaCBTp) 的初步评估。目的：我们的目的是在巴基斯坦的一个试点项目中评估适应文化的 CBT 治疗精神病 (CaCBTp) 的功效。方法：在一项随机对照试验中，我们在巴基斯坦住院患者中测试了 CaCBTp 与常规治疗 (TAU) 的比较。那些根据 DSM-IV-TR 诊断为精神分裂症并符合纳入标准的人被招募到该研究中。患者 (n = 42) 被随机分为两个相等的组，即 CaCBTp 和 TAU。由不知道分组的评估者在基线和治疗结束时进行评估。使用 PANSS（精神分裂症阳性和阴性综合症量表）、PSYRATS（精神病症状评定量表）和 Insight 量表来测量精神病理学。结果：接受 CaCBTp 的患者在治疗结束时，在阳性症状 (p = .000)、阴性症状 (p = .000)、总体精神病症状 (p = .000)、幻觉 (p = .000)、妄想 (p = .000) 和自知力 (p = .000) 方面显示出统计学上显着的改善。结论：CaCBTp 可有效减少巴基斯坦住院患者的精神病症状并提高洞察力。
Background: Cognitive Behaviour Therapy for Psychosis (CBTp) has a strong evidence base and is practised widely in the Western World. Psycho-social interventions, on the other hand, including Cognitive Behaviour Therapy (CBT) are hardly used in the low and middle income countries for psychosis. It has been suggested that adaptations in content, format and delivery are needed before CBT can be used outside the Western cultures. We describe preliminary evaluation of Culturally Adapted Cognitive Behaviour Therapy for Psychosis (CaCBTp) in in-patient settings in Lahore, Pakistan. Aims: We aimed to evaluate the efficacy of culturally adapted CBT for psychosis (CaCBTp) in Pakistan in a pilot project. Method: In a randomized controlled trial we tested CaCBTp against treatment as usual (TAU) in in-patient settings in Pakistan. Those diagnosed with schizophrenia according to the DSM-IV-TR, and who fulfilled the inclusion criteria, were recruited into the study. Patients (n = 42) were randomized into two equal groups, i.e. CaCBTp and TAU. Assessments were carried out both at the baseline and then at the end of the therapy by raters blind to the groupings. Psychopathology was measured using PANSS (Positive and Negative Syndrome Scale of Schizophrenia), PSYRATS (Psychotic Symptom Rating Scales), and the Insight Scale. Results: Patients receiving CaCBTp showed statistically significant improvement on measures of positive symptoms (p = .000), negative symptoms (p = .000), overall psychotic symptoms (p = .000), hallucinations (p = .000), delusions (p = .000) and insight (p = .000) at the end of the therapy. Conclusions: The CaCBTp was effective in reducing symptoms of psychosis and in improving insight in in-inpatient settings in Pakistan.