Assertive community treatment versus standard treatment for severely mentally ill patients in Denmark: a quasi-experimental trial
Assertive community treatment versus standard treatment for severely mentally ill patients in Denmark: a quasi-experimental trial
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丹麦严重精神病患者的积极社区治疗与标准治疗：一项准实验性试验
DOI：
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发表时间：
2019
影响因子：
1.8
通讯作者：
M. Nordentoft
中科院分区：
文献类型：
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作者：
Marie Hoegh Thoegersen;Britt Morthorst;M. Nordentoft
摘要背景：自信的社区治疗的未来是不确定的，研究质疑它是否继续在现代精神健康背景下为严重精神疾病患者提供更有效的治疗模式。在新的环境下进行的研究可能有助于这场辩论。方法：这项丹麦研究采用非盲法准实验多中心试验，比较了自信社区治疗和标准社区精神卫生小组治疗的疗效。结果包括与精神卫生服务机构的接触、入院天数、非自愿入院天数、门诊接触次数、对抗精神病药物的坚持、社会功能、用户满意度和精神病理学。结果：共有366名患者被纳入试验，这些患者接受了积极的社区治疗(n = ，213人)或社区精神卫生团队的持续护理(n， = ，153人)。积极的社区治疗在维持与患者的接触方面明显更好。在两年的随访中，接受自信社区治疗的患者中有16人(8%)与接受标准治疗的患者中的22人(14%)失去了与治疗的联系。接受自信的社区治疗的患者在住院服务使用方面有更大的减少，对抗精神病药物的依从性增加，社会功能得到改善，用户满意度更高。在非自愿入院天数和精神病理学方面没有发现差异。结论：结果表明，高保真、自信的社区治疗可能是加强严重精神病患者与治疗人员之间联系的有价值的工具，并可能有助于改善现代丹麦精神健康背景下的结果。
Abstract Background: The future of assertive community treatment is uncertain, and studies have questioned whether it continues to provide a more effective treatment model for severely mentally ill patients in a modern mental health context. Studies conducted in new settings can contribute to the debate. Methods: This Danish study compares treatment from assertive community treatment with treatment by standard community mental health teams, using a non-blinded quasi-experimental multi-center trial. Outcomes included contact with mental health services, days of admission, days of involuntary admission, number of outpatient contacts, adherence to antipsychotic medication, social functioning, user satisfaction, and psychopathology. Results: A total of 366 patients receiving treatment from assertive community treatment (n = 213) or continuation of care from community mental health teams (n = 153) were included in the trial. Assertive community treatment was significantly better in sustaining contact with patients. At 2-year follow-up, 16 (8%) of patients receiving assertive community treatment versus 22(14%) receiving care from standard treatment had lost contact with treatment. Patients who received assertive community treatment had a larger reduction in inpatient service-use, increased adherence to antipsychotic medication, improved social functioning, and higher user satisfaction. No differences in days of involuntary admission and psychopathology were found. Conclusions: The results suggest that a high fidelity assertive community treatment may be a valuable tool to strengthen contact between severely mentally ill patients and the treatment staff and may contribute to improving outcomes in a modern Danish mental health context.
影响因子：
5.9
作者：
McGrew,JH;Bond,GR;Dietzen,L;Salyers,M
通讯作者：
Salyers,M