A Systematic Review and Meta-Analysis of Recovery in Schizophrenia
A Systematic Review and Meta-Analysis of Recovery in Schizophrenia
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DOI：
10.1093/schbul/sbs130
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发表时间：
2013-11-01
影响因子：
6.6
通讯作者：
Miettunen, Jouko
中科院分区：
文献类型：
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作者：
Jaaskelainen, Erika;Juola, Pauliina;Miettunen, Jouko
目的：我们的主要目的是（a）确定符合临床和社会领域恢复标准的精神分裂症和相关精神病患者的比例，（B）检查恢复是否与性别、研究中心的经济指数和研究的选定设计特征等因素相关。我们还检查了符合我们对恢复定义的比例是否随时间而变化。方法：采用综合检索策略识别潜在研究，并提取符合纳入标准的数据。从每项研究中提取符合我们的恢复标准（临床和社会领域的改善，以及这两个领域中至少有一个领域的改善持续至少2年的证据）的比例。采用荟萃回归技术探讨回收率与所选变量之间的关系。结果：我们确定了50项数据适合纳入的研究。符合我们的恢复标准的中位比例（25%-75%分位数）为13.5%（8.1%-20.0%）。经济状况较差国家研究中心的回收率较高。然而，当根据性别、摄入期中点、诊断标准的严格程度、随访持续时间或其他设计特征对估计值进行分层时，没有统计学显著差异。结论：根据现有的最佳数据，大约有1/7的精神分裂症患者符合我们的康复标准。尽管近几十年来治疗方案发生了重大变化，但治愈病例的比例并没有增加。
Objective: Our primary aims were (a) to identify the proportion of individuals with schizophrenia and related psychoses who met recovery criteria based on both clinical and social domains and (b) to examine if recovery was associated with factors such as gender, economic index of sites, and selected design features of the study. We also examined if the proportions who met our definition of recovery had changed over time. Method: A comprehensive search strategy was used to identify potential studies, and data were extracted for those that met inclusion criteria. The proportion who met our recovery criteria (improvements in both clinical and social domains and evidence that improvements in at least 1 of these 2 domains had persisted for at least 2 years) was extracted from each study. Meta-regression techniques were used to explore the association between the recovery proportions and the selected variables. Results: We identified 50 studies with data suitable for inclusion. The median proportion (25%-75% quantiles) who met our recovery criteria was 13.5% (8.1%-20.0%). Studies from sites in countries with poorer economic status had higher recovery proportions. However, there were no statistically significant differences when the estimates were stratified according to sex, midpoint of intake period, strictness of the diagnostic criteria, duration of follow-up, or other design features. Conclusions: Based on the best available data, approximately, 1 in 7 individuals with schizophrenia met our criteria for recovery. Despite major changes in treatment options in recent decades, the proportion of recovered cases has not increased.