BACKGROUND:Crisis happens daily yet its understanding is often limited, even in the field of psychiatry. Indeed, a challenge is to assess the potential for change of patients so as to offer appropriate therapeutic interventions and enhance treatment program efficacy. This naturalistic study aimed to identify the socio-demographical characteristics and clinical profiles at admission of patients referred to a specialized Crisis Intervention Center (CIC) and to examine the effectiveness of the intervention. METHOD:The sample was composed of 352 adult outpatients recruited among the referrals to the CIC. Assessment completed at admission and at discharge examined psychiatric symptoms, defense mechanisms, recovery styles and global functioning. The crisis intervention consisted in a psychodynamically oriented multimodal approach associated with medication. RESULTS:Regarding the clinical profiles at intake, patients were middle-aged (M = 38.56, SD = 10.91), with a higher proportion of women (62.22%). They were addressed to the CIC because they had attempted to commit suicide or had suicidal ideation or presented depressed mood related to interpersonal difficulties. No statistical differences were found between patients dropping out (n = 215) and those attending the crisis intervention (n = 137). Crisis intervention demonstrated a beneficial effect (p < 0.01) on almost all variables, with Effect Sizes (ES) ranging from small to large (0.12 < ES < 0.75; median = 0.49). However, the Reliable Change Index indicated that most of the issues fall into the undetermined category (range 41.46 to 96.35%; median = 66.20%). CONCLUSIONS:This study establishes the profile of patients referred to the CIC and shows that more than half of the patients dropped out from the crisis intervention before completion. Our findings suggest that people presenting an emotional crisis benefit from crisis intervention. However, given methodological constraints, these results need to be considered with caution. Moreover, the clinical significance of the improvements is not confirmed. Thus, the effectiveness of crisis intervention in naturalistic context is not fully determined and should be more rigorously studied in future research.

译文

背景:危机每天都在发生,但即使在精神病学领域,其理解也常常受到限制。确实,挑战在于评估患者改变的可能性,以提供适当的治疗干预并增强治疗程序的有效性。这项自然主义的研究旨在确定患者入院时的社会人口统计学特征和临床特征,并转交给专门的危机干预中心(CIC),并检查干预措施的有效性。
方法:该样本由352名在CIC转诊中招募的成人门诊患者组成。入院和出院时完成的评估检查了精神症状,防御机制,恢复方式和整体功能。危机干预包括与药物治疗相关的面向心理动力学的多式联运方法。
结果:就摄入时的临床情况而言,患者为中年患者(M = 38.56,SD = 10.91),女性比例更高(62.22%)。他们之所以向CIC寻求帮助,是因为他们曾试图自杀或有自杀念头,或表现出与人际交往困难有关的沮丧情绪。辍学的患者(n = 215)与参加危机干预的患者(n = 137)之间没有发现统计差异。危机干预对几乎所有变量都显示出有益的影响(p <0.01),影响大小(ES)从小到大(0.12 结论:该研究建立了被称为CIC的患者的概况,并显示超过一半的患者在完成之前退出了危机干预。我们的研究结果表明,呈现情感危机的人们可以从危机干预中受益。但是,由于方法上的限制,需要谨慎考虑这些结果。而且,尚未确认该改善的临床意义。因此,在自然主义背景下危机干预的有效性尚未完全确定,应在以后的研究中进行更严格的研究。

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