پژوهشگران دانشگاه اوسلو نروژ و دانشگاه دالهوزی کانادا به بررسی تاثیر رواندرمانی پویشی فشرده کوتاه مدت، ISTDP بر بیماران مقاوم به درمان پرداختند.
???روش پژوهش
در این پژوهش آزمایشی ۶۰ بیمار داوطلب دارای چندین شکست در درمان و بیماری فعلی روانی، میزان کژکاری لازم برای بستری شدن شرکت نمودند. شاخصهای ارزیابی شامل سنجش استرس، اضطراب، کژکاری نقش اجتماعی، دیسترس بین فردی، دیسترس کلی نشانه مرضی، و کارکردهای بین فردی بودند. گروه آزمایش۸ جلسه فردی هفتگی ۹۰ دقیقه ISTDP فردی و ۱۶ جلسه رواندرمانی گروهی ۹۰ دقیقه ای در هر هفته دو جلسه دریافت نمودند.
??? نتایج نشان دادند:
- ISTDP بر بیماران مقاوم به درمان در تمامی شاخصهای سنجش تاثیر مثبت داشته است.
- رواندرمانی معمول تاثیری بر بیماران مقاوم به درمان نداشت.
- بعد از ۱۴ ماه از اختتام رواندرمانی پویشی فشرده کوتاه مدت، ۵۰ درصد از بیماران از نشانههای مزمن رهایی یافته بودند؛ ۵۳ درصد بیماران از دیسترس کلی نشانه مرضی و ۴۸ درصد درکارکردهای بین فردی بهبود یافته بودند.
- ISTDP بر بیماران مقاوم به درمان که در بخشهای روانپزشکی بستری هستند نتایج بسیار مطلوبی داشته و در کاهش رنجهای روانی آنها، کاهش مدت درمان، کاهش علایم و بهبود کیفیت و رضایت از درمان تاثیر شگرفی دارد.
Intensive short-term dynamic residential treatment program for patients with treatment-resistant disorders
Abstract
Background
The study investigated the effectiveness of an Intensive Short-Term Dynamic (ISTDP) residential treatment program for patients with treatment resistant anxiety- and/or depressive disorders, with and without comorbid personality disorders.
Method
A non-randomized controlled trial examined the effects of an eight week intensive residential treatment program based on principles from ISTDP. Patients (N=60), who had repeated prior treatment failure for current mental disorder, sufficient dysfunction to warrant hospitalization, and evidencing capacity to take an intrapsychic perspective on own problems, were included.
Outcome variables included measures of target complaints (depression/anxiety, social role dysfunction, and interpersonal distress), general symptom distress, and interpersonal functioning.
Measures were administered throughout and after treatment. Change was assessed by multilevel growth curve modeling. Changes during and after treatment were compared to those reported by a sub-sample of wait-list controls taking treatment as usual (N=30).
Results
The treatment group evidenced significant improvements on all measures. By contrast, receiving treatment as usual while on the wait-list did not yield significant changes. Effect sizes in the treatment group were consistently large at both termination and follow-up.
Fourteen months after treatment 50.0% of patients had recovered in terms of target complaints. Approximately 53.3% and 48.3%, respectively, had recovered in terms of general symptom distress and interpersonal functioning.
Limitations
Limitations included a relatively small sample size, inability to discern the effectiveness of separate components of the treatment program, and lack of randomization of patients to wait-list and treatment.
Conclusion
ISTDP-based residential treatment with an eight-week time-limit appears to be effective for alleviating common and severe, treatment resistant mental disorders.
The treatment program was superior to receiving treatment as usual while on the wait-list. Participation in the program quickly reduced target complaints, symptoms and interpersonal problems for patients who, based on previous treatment experiences, were expected to fare poorly in treatment. Gains were consistently maintained or improved further at follow-up.
Results are promising for patients with chronic debilitating problems who often do not profit from traditional psychiatric treatment.
Keywords
Short-term, Treatment resistance, Anxiety, Depression, Personality disorder, Psychodynamic psychotherapy.
لینک منبع پیشنهادی برای مطالعه بیشتر (further reading)
(در صورت جذابیت و علاقمندی به موضوع، مطلب را برای دیگران نیز بازنشر فرمایید).
کانال تلگرام
https://t.me/DrAmirMohammadShahsavarani
اینستاگرام
دیدگاهتان را بنویسید