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首页> 外文期刊>The British journal of psychiatry : >Cognitive--behavioural therapy and family intervention for relapse prevention and symptom reduction in psychosis: randomised controlled trial.
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Cognitive--behavioural therapy and family intervention for relapse prevention and symptom reduction in psychosis: randomised controlled trial.

机译：认知行为疗法和家庭干预预防精神病的复发和减轻症状：随机对照试验。

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BACKGROUND: Family intervention reduces relapse rates in psychosis. Cognitive-behavioural therapy (CBT) improves positive symptoms but effects on relapse rates are not established. AIMS: To test the effectiveness of CBT and family intervention in reducing relapse, and in improving symptoms and functioning in patients who had recently relapsed with non-affective psychosis. METHOD: A multicentre randomised controlled trial (ISRCTN83557988) with two pathways: those without carers were allocated to treatment as usual or CBT plus treatment as usual, those with carers to treatment as usual, CBT plus treatment as usual or family intervention plus treatment as usual. The CBT and family intervention were focused on relapse prevention for 20 sessions over 9 months. RESULTS: A total of 301 patients and 83 carers participated. Primary outcome data were available on 96% of the total sample. The CBT and family intervention had no effects on rates of remission and relapse or on days in hospital at 12 or 24 months. For secondary outcomes, CBT showed a beneficial effect on depression at 24 months and there were no effects for family intervention. In people with carers, CBT significantly improved delusional distress and social functioning. Therapy did not change key psychological processes. CONCLUSIONS: Generic CBT for psychosis is not indicated for routine relapse prevention in people recovering from a recent relapse of psychosis and should currently be reserved for those with distressing medication-unresponsive positive symptoms. Any CBT targeted at this acute population requires development. The lack of effect of family intervention on relapse may be attributable to the low overall relapse rate in those with carers.
机译：背景：家庭干预可降低精神病的复发率。认知行为疗法（CBT）可以改善阳性症状，但对复发率的影响尚未确立。目的：测试CBT和家庭干预在减少复发，改善近期非情感性精神病复发患者中的症状和功能方面的有效性。方法：一项多中心随机对照试验（ISRCTN83557988），该试验有两种途径：无护理者被分配为常规治疗或CBT加常规治疗，有护理者为常规治疗，CBT加常规治疗或家庭干预加常规治疗。 CBT和家庭干预的重点是在9个月内预防20次复发。结果：共有301例患者和83名护理人员参加。主要结果数据可用于总样本的96％。 CBT和家庭干预对缓解和复发率或12或24个月住院天数没有影响。对于次要结局，CBT在24个月时对抑郁症显示出有益的效果，而家庭干预则没有效果。在有护理人员的人群中，CBT显着改善了妄想困扰和社会功能。治疗并没有改变关键的心理过程。结论：对于从最近的精神病复发中恢复过来的人，常规治疗精神病的常规CBT不能用于预防复发，目前应保留给那些对药物无反应的阳性症状感到困扰的人。针对这种急性人群的任何CBT都需要发展。家庭干预对复发的影响不足可能归因于护理人员的总体复发率低。

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