Effectiveness of psychoeducation for relapse, symptoms, knowledge, adherence and functioning in psychotic disorders: A meta-analysis
Effectiveness of psychoeducation for relapse, symptoms, knowledge, adherence and functioning in psychotic disorders: A meta-analysis
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DOI：
10.1016/j.schres.2007.07.022
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发表时间：
2007-11-01
影响因子：
4.5
通讯作者：
Nestoriuc, Y.
中科院分区：
文献类型：
--
作者：
Lincoln, T. M.;Wilhelm, K.;Nestoriuc, Y.
精神分裂症和其他精神障碍的心理教育（PE）被广泛采用，但评估不足。到目前为止，荟萃分析数据已经证明，当干预包括家庭成员时，PE是有效的。单独针对患者的PE是否也有效尚不清楚。当前的荟萃分析评估了PE的短期和长期疗效，包括和不包括复发、症状减轻、知识、药物依从性和功能。随机对照试验比较PE与标准治疗或非特异性干预。通过Cochrane图书馆、PsycINFO和Medline的文献检索，我们检索了199项研究进行更仔细的检查，其中18项研究报告了19项比较，符合纳入标准。这些研究根据方法、参与者、干预措施和有效性进行编码。采用固定效应模型对均匀效应进行整合，采用随机效应模型对异质效应进行整合。与治疗方式无关，PE对治疗后复发的影响中等，对知识的影响较小。PE对症状、功能和药物依从性没有影响。治疗后12个月复发和再住院的效应量仍然显著，但在更长的随访期间没有显著性。包括家庭在内的干预措施在治疗结束时减轻症状和预防7-12个月随访时复发方面更有效。单独针对患者的PE效果不显著。综上所述，将家庭融入体育的额外努力是值得的，而仅以患者为中心的干预措施需要进一步改进和研究。(C) 2007 Elsevier B.V.版权所有
Psychoeducation (PE) for schizophrenia and other psychotic disorders is widely adopted but insufficiently evaluated. So far, meta-analytic data has demonstrated efficacy for PE when interventions include family members. Whether PE directed solely at patients is also effective remains unclear. The current meta-analysis evaluates short- and long-term efficacy of PE with and without inclusion of families with regard to relapse, symptom-reduction, knowledge, medication adherence, and functioning.Randomized controlled trials comparing PE to standard care or non-specific interventions were included. A literature search in the Cochrane Library, PsycINFO and Medline retrieved 199 studies for closer examination, of which 18 studies, reporting on 19 comparisons, met the inclusion criteria. These studies were coded with regard to methodology, participants, interventions and validity. Effect sizes were integrated using the fixed effects model for homogeneous effects and the random effects model for heterogeneous effects.Independent of treatment modality, PE produced a medium effect at post-treatment for relapse and a small effect size for knowledge. PE had no effect on symptoms, functioning and medication adherence. Effect sizes for relapse and rehospitalization remained significant for 12 months after treatment but failed significance for longer follow-up periods. Interventions that included families were more effective in reducing symptoms by the end of treatment and preventing relapse at 7-12 month follow-up. Effects achieved for PE directed at patients alone were not significant.It is concluded that the additional effort of integrating families in PE is worthwhile, while patient-focused interventions alone need further improvement and research. (C) 2007 Elsevier B.V. All rights reserved.