Effect of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia: A randomized, 1-year study.
Effect of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia: A randomized, 1-year study.
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DOI：
10.1001/archgenpsychiatry.2010.105
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发表时间：
2010-09
影响因子：
--
通讯作者：
Zhao, Jingping
中科院分区：
文献类型：
--
作者：
Guo, Xiaofeng;Zhai, Jinguo;Liu, Zhening;Fang, Maosheng;Wang, Bo;Wang, Chuanyue;Hu, Bin;Sun, Xueli;Lv, Luxian;Lu, Zheng;Ma, Cui;He, Xiaolin;Guo, Tiansheng;Xie, Shiping;Wu, Renrong;Xue, Zhimin;Chen, Jindong;Twamley, Elizabeth W.;Jin, Hua;Zhao, Jingping
抗精神病药物在改善精神分裂症总体预后方面的能力有限。添加社会心理治疗可能比单独的药物治疗在功能预后方面产生更大的改善。
为了评估单独使用抗精神病药物与联合社会心理干预对早期精神分裂症预后的有效性。
2005年至2007年在中国10个临床地点对1268例早期精神分裂症患者的临床样本进行的随机对照试验。
患者被随机分配到仅接受抗精神病药物治疗组或抗精神病药物加12个月社会心理干预组，社会心理干预包括心理教育、家庭干预、技能培训和认知行为疗法，通过48次小组课程进行。
因任何原因导致的治疗中断或改变的比率、复发或缓解情况，以及自知力、治疗依从性、生活质量和社会功能的评估。
联合治疗组因任何原因导致的治疗中断或改变的比率为32.8%，单独药物治疗组为46.8%。与单独药物治疗相比，联合治疗因任何原因中断的风险更低（风险比[HR]，0.62；95%置信区间[CI]，0.52 - 0.74；p < 0.001）；联合治疗复发的风险更低（HR，0.57；95%CI，0.44 - 0.74；p < 0.001）。联合治疗组在自知力（p < 0.001）、社会功能（p = 0.002）、日常生活活动（p < 0.001）以及通过医疗结果研究简表36项问卷测量的生活质量的4个领域都有更大的改善（所有p值< 0.02）。此外，接受联合治疗的患者获得就业或接受教育的比例显著更高（p = 0.001）。
与仅接受药物治疗的患者相比，接受药物和社会心理干预的早期精神分裂症患者治疗中断或改变的比率更低，复发风险更低，并且自知力、生活质量和社会功能都有所改善。
Antipsychotic drugs are limited in their ability to improve the overall outcome of schizophrenia. Adding psychosocial treatment may produce greater improvement in functional outcome than does medication treatment alone. To evaluate the effectiveness of antipsychotic medication alone versus combined with psychosocial intervention on outcomes of early stage schizophrenia. Randomized controlled trial of a clinical sample of 1268 patients with early stage schizophrenia, conducted at 10 clinical sites in China from 2005–2007. Patients were randomly assigned to antipsychotic medication treatment only or antipsychotic medication plus 12 months of psychosocial intervention, consisting of psycho-education, family intervention, skills training and cognitive-behavioral therapy, administered over 48 group sessions. The rate of treatment discontinuation or change due to any cause, relapse or remission, and assessments of insight, treatment adherence, quality of life and social functioning. The rates of treatment discontinuation or change due to any cause were 32.8% in the combined treatment group and 46.8% in the medication alone group. Comparisons with medication treatment alone showed lower risk for any cause discontinuation with combined treatment (hazard ratios [HR], 0.62; 95% confidence interval [CI], 0.52–0.74; p<0.001); and lower risk for relapse with combined treatment (HR, 0.57; 95%CI, 0.44–0.74; p<0.001). The combined treatment group exhibited greater improvement in insight (p<0.001), social functioning (p=0.002), activities of daily living (p<0.001), and in 4 domains of quality of life as measured by Medical Outcome Study Short-Form 36-item questionnaire (all p-values<0.02). Furthermore, a significantly higher proportion of patients receiving combined treatment obtained employment or accessed education (p=0.001). Compared to those receiving medications only, early stage schizophrenia patients receiving medications and psychosocial intervention had a lower rate of treatment discontinuation or change, lower risk of relapse, and improved insight, quality of life and social functioning.
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影响因子：
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