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治疗耐药精神分裂症的心理和心理社会干预:系统性审查和网络元分析
Nurul Husna Salahuddin1, Alexandra Schütz1, Gabi Pitschel-Walz2
1Department of Psychiatry and Psychotherapy, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
The lancet. Psychiatry
|June 15, 2024
概括
对于精神病的认知行为疗法 (CBTp) 有效地减少了治疗耐药精神分裂症的症状. 这一发现支持CBTp作为临床医生管理这一患者群体的优先干预措施.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 基于证据的医学基于证据的医学.
背景情况:
- 耐治疗精神分裂症 (TRS) 影响了许多对抗精神病药物不反应的患者.
- 心理和心理社会干预可以使TRS患者受益,作为附加治疗.
- 这些干预措施对TRS的比较有效性尚未得到充分证实.
研究的目的:
- 调查TRS心理和心理社会干预措施的有效性,可接受性和耐受性.
- 为了将这些干预措施与彼此和标准护理进行比较.
主要方法:
- 随机对照试验 (RCT) 的系统审查和网络元分析 (NMA).
- 在多个数据库中搜索到2023年7月的涉及TRS患者的RCT.
- 主要结局是整体症状减少;进行了随机效应元分析和NMA.
主要成果:
- 在NMA中包括了60项与5034名参与者的研究.
- 对精神病的认知行为疗法 (CBTp) 显示出显著的疗效 (SMD -0.22).
- 虚拟现实,综合干预和音乐治疗也显示出希望,但需要进一步研究.
结论:
- CBTp是一种强大的干预措施,用于减少治疗耐药精神分裂症的整体症状.
- 临床医生应该考虑在TRS患者的临床实践中优先考虑CBTp.
- 其他干预措施显示出潜力,需要进一步调查.
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