在住宿中使用物质治疗的认知补救:一个随机的阶段式形试验
Talia Nardo1,2, Jamie Berry1,2, Daniel Barker3,4
1Department of Psychology, Macquarie University, North Ryde, NSW, Australia.
Neuropsychological rehabilitation
|February 15, 2024
概括
在初步分析中,认知补救 (CR) 没有显著改善在物质使用障碍 (SUD) 患者的执行功能或治疗保留. 然而,每项方案分析表明,CR改善了SUD患者的执行功能和治疗毕业率.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
背景情况:
- 执行功能障碍是物质使用障碍 (SUD) 患者面临的重大挑战,影响治疗的参与和保留.
- 认知补救 (CR) 提供了一种潜在的策略,以解决这些认知缺陷,并改善SUD人群的治疗结果.
研究的目的:
- 评估认知补救 (CR) 在增强执行功能和增加SUD成年人治疗持久性的有效性.
- 为了将CR干预与常规治疗 (TAU) 进行比较,在一个阶梯集群中随机对照试验设计.
主要方法:
- 一个阶梯集群随机对照试验,涉及澳大利亚新南威尔士州10个住宅SUD治疗设施的527名成年人.
- 干预组在六周内接受了12小时的基于组的CR,而对照组接受了TAU.
- 主要结局包括自我报告的执行功能和完成治疗的比例 (PoTC);进行了治疗意图 (ITT) 和每协议 (PP) 分析.
主要成果:
- ITT分析显示,CR和TAU组之间在自我报告的执行功能 (p=.059) 或PoTC (p=.442) 中没有显著差异.
- 一个后期的PP分析,占高退学率 (56%在ITT),显示CR显著改善了自我报告的执行功能 (p=.019).
- PP分析还表明,接受CR的参与者治疗渐进的可能性显著更高 (调整后OR=2.43,p<.001).
结论:
- 虽然最初的ITT分析没有支持CR在SUD治疗保留方面的有效性,但PP分析表明对执行职能和毕业的潜在益处.
- 高退学率需要进一步研究,以优化CR交付,以便在SUD中广泛有效治疗.
- 未来的研究应该专注于改进CR方法,以确保在SUD中对执行职能和治疗完成产生强大的服务范围的影响.
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