PLoS ONE：德国入院心理疗法或可有效治疗精神疾病

  来自汉堡大学医学中心等处的科学家近日回顾了1977至2009年的59项研究，证实了在德国广泛使用的病人住院心理疗法在减少个体精神症状及人际交往障碍上是非常有效的，相关研究“Do Patients’ Symptoms and Interpersonal Problems Improve in Psychotherapeutic Hospital Treatment in Germany？-A Systematic Review and Meta-Analysis.”于近日刊登于国际杂志PLoS ONE上。
  文章中，研究者Sven Rabung说道，提供这种心理治疗方法的医院及提供心理治疗服务的专家部门最早包括个人和一些心理治疗团队，他们会在对患者的治疗过程中不断增加一些治疗措施；在心理治疗方面德国与其它国家不同，在德国患精神障碍的患者通常仅在精神病医院接受住院治疗，因此患者在医院可以得到更多的药物治疗，而每一年在德国都有超过一百万的患者进行这种入院的治疗方式来治疗心理障碍。
  研究者表示，不论患者的疾病严重程度及是否疾病和人际交往有关，心理治疗医院的疗法都会对严重疾病的患者产生有益的作用，而研究者重点检测了患者症状严重性和其人际交往障碍之间的关联；最后研究者指出，患者入院的心理疗法还需要进行更为深入的研究来阐明其对患者的重要性和有效性。（转化医学网360zhyx.com）
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Do Patients’ Symptoms and Interpersonal Problems Improve in Psychotherapeutic Hospital Treatment in Germany? - A Systematic Review and Meta-Analysis
PLoS ONE doi:10.1371/journal.pone.0105329
Sarah Liebherz, Sven Rabung
Background
In Germany, inpatient psychotherapy plays a unique role in the treatment of patients with common mental disorders of higher severity. In addition to psychiatric inpatient services, psychotherapeutic hospital treatment and psychosomatic rehabilitation are offered as independent inpatient treatment options. This meta-analysis aims to provide systematic evidence for psychotherapeutic hospital treatment in Germany regarding its effects on symptomatic and interpersonal impairment.
Methodology
Relevant papers were identified by electronic database search and hand search. Randomized controlled trials as well as naturalistic prospective studies (including post-therapy and follow-up assessments) evaluating psychotherapeutic hospital treatment of mentally ill adults in Germany were included. Outcomes were required to be quantified by either the Symptom-Checklist (SCL-90-R or short versions) or the Inventory of Interpersonal Problems (IIP-64 or short versions). Effect sizes (Hedges’ g) were combined using random effect models.
Principal Findings
Sixty-seven papers representing 59 studies fulfilled inclusion criteria. Meta-analysis yielded a medium within-group effect size for symptom change at discharge (g = 0.72; 95% CI 0.68–0.76), with a small reduction to follow-up (g = 0.61; 95% CI 0.55–0.68). Regarding interpersonal problems, a small effect size was found at discharge (g = 0.35; 95% CI 0.29–0.41), which increased to follow-up (g = 0.48; 95% CI 0.36–0.60). While higher impairment at intake was associated with a larger effect size in both measures, longer treatment duration was related to lower effect sizes in SCL GSI and to larger effect sizes in IIP Total.
Conclusions
Psychotherapeutic hospital treatment may be considered an effective treatment. In accordance with Howard’s phase model of psychotherapy outcome, the present study demonstrated that symptom distress changes more quickly and strongly than interpersonal problems. Preliminary analyses show impairment at intake and treatment duration to be the strongest outcome predictors. Further analyses regarding this relationship are required.