Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders
Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders
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DOI：
10.1176/appi.ajp.158.10.1706
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发表时间：
2001-10-01
影响因子：
17.7
通讯作者：
McGovern, J
中科院分区：
文献类型：
--
作者：
Barrowclough, C;Haddock, G;McGovern, J
目的：物质滥用障碍与精神分裂症的共病与严重疾病、并发症和预后不良的风险更大相关。对这些疾病患者的治疗方法进行研究的方法健全的研究很少见，尽管对综合和综合治疗计划的建议比比皆是。这项研究调查了在精神分裂症和药物使用障碍患者的常规精神护理中增加心理和社会心理综合治疗方案的相对益处。作者对常规护理与常规护理结合激励性访谈、认知行为治疗和家庭或照顾者干预的方案进行了随机、单盲对照比较。结果：在治疗结束时和研究开始后12个月，综合治疗方案对患者总体功能的改善显著高于单独常规护理。该计划的其他好处包括从基线到随访的12个月期间，阳性症状和症状恶化的减少，以及戒毒或戒酒天数的增加。结论：这些发现表明，对于合并精神分裂症和酒精或药物滥用或依赖的患者，结合励志访谈、认知行为治疗和家庭干预的常规护理计划比单纯的常规精神护理有效。
Objective: Comorbidity of substance abuse disorders with schizophrenia is associated with a greater risk for serious illness complications and poorer outcome. Methodologically sound studies investigating treatment approaches for patients with these disorders are rare, although recommendations for integrated and comprehensive treatment programs abound. This study investigates the relative benefit of adding an integrated psychological and psychosocial treatment program to routine psychiatric care for patients with schizophrenia and substance use disorders.Method. The authors conducted a randomized, single-blind controlled comparison of routine care with a program of routine care integrated with motivational interviewing, cognitive behavior therapy, and family or caregiver intervention.Results: The integrated treatment program resulted in significantly greater improvement in patients' general functioning than routine care alone at the end of treatment and 12 months after the beginning of the study. Other benefits of the program included a reduction in positive symptoms and in symptom exacerbations and an increase in the percent of days of abstinence from drugs or alcohol over the 12-month period from baseline to follow-up.Conclusions: These findings demonstrate the effectiveness of a program of routine care integrated with motivational interviewing, cognitive behavior therapy, and family intervention over routine psychiatric care alone for patients with comorbid schizophrenia and alcohol or drug abuse or dependence.