Predicting engagement with services for psychosis: insight, symptoms and recovery style
Predicting engagement with services for psychosis: insight, symptoms and recovery style
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DOI：
10.1192/bjp.182.2.123
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发表时间：
2003-02-01
影响因子：
10.5
通讯作者：
Trower, P
中科院分区：
文献类型：
--
作者：
Tait, L;Birchwood, M;Trower, P
背景 治疗不依从和服务脱离通常归因于洞察力受损。有证据表明，恢复方式（即心理调整）可能是服务参与的基础。 目的 我们检查了自知力精神病症状或个人的恢复方式（“整合”与“封闭”）是否可以预测服务参与。方法 对 50 名精神分裂症患者在急性精神病期间以及 3 个月和 6 个月的随访中进行了评估。衡量标准包括康复方式、精神病症状、洞察力和服务参与度。结果精神病发作后 3 个月的封闭预测 6 个月时服务参与度较低。洞察力和症状都无法预测参与度。前 3 个月内从整合到封闭的明显转变与症状或洞察力的变化无关。 3 至 6 个月之间的封闭与精神病症状的改善相关。 结论 恢复方式比洞察力对参与度的贡献更大，在短期内似乎是动态的，并且与洞察力正交。总体而言，这项研究证明了在调查精神病患者的治疗参与度时解决精神病心理调整以及疾病状态的重要性。
Background Treatment nonadherence and service disengagement are commonly attributed to impaired insight. There is evidence that recovery style (i.e. psychological adjustment) may underlie service engagement.Aims We examined whether insight psychotic symptoms or individuals' recovery style ('integration' v. 'sealing-over') predicts service engagement.Method Fifty patients with schizophrenia were assessed during acute psychosis and at 3-month and 6-month follow-ups. Measures included recovery style, psychosis symptoms, insight and service engagement.Results Sealing-over at 3 months following onset of an episode of psychosis predicted low service engagement at 6 months. Neither insight nor symptoms predicted engagement. The clear shift from integration to sealing-over within the first 3 months was independent of changes in symptoms or insight. Sealing-over between 3 and 6 months was associated with improvement in psychosis symptoms.Conclusions Recovery style contributed more to engagement than did insight, appears to be dynamic in the short term and is orthogonal to insight. Overall, this study demonstrated the importance of addressing psychological adjustment to psychosis as well as illness status when investigating treatment engagement in people with psychosis.