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Заключение
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В результате нескольких исследований не было найдено доказательств самостоятельной эффективности психотерапии без применения лекарственных средств в условиях стационарного лечения больных шизофренией. Преимущества же комплексной лекарственной и психосоциальной терапии по сравнению с медикаментозной монотерапией в тех же условиях были незначительными и непостоянными. В целом психотерапевтическое вмешательство в большей степени соответствует лечению в амбулаторных условиях. Подобное лечение можно сравнить с тем, как лечебная физкультура способствует процессу заживлению перелома при переломе ноги после периода иммобилизации.
Практический врач должен рассудительно подходить к выбору соответствующего социо-и психотерапевтического воздействия для конкретных больных. Такой выбор должен быть, несомненно, практически действенным, а не основываться на каких-то особых теоретических положениях. И, наконец, некоторые сложные, дорогостоящие и длительные психотерапевтические мероприятия часто не имеют никаких преимуществ перед более экономичными моделями.
Литература
1. May PRA, Тшпа АН, Dixon WJ. Schizophrenia -a follow-up study of results of treatment. I. Design and other problems. Arch Gen Psychiatry 1976-33; 474-478.
2. May PRA, Tuma AH, Yale C, Potepan P, Dixon WJ. Schizophrenia — a follow-up study of results of treatment. II. Hospital stay over two to five years. Arch Gen Psychiatry 1976; 33: 481-486.
3. Grinspoon L, Ewalt JR, Shader RI. Schizophrenia: pharmacotherapy and psychotherapy. Baltimore: Williams & Wilkins, 1968: 67-74.
4. Grinspoon L, Ewalt JR, Shader RI. Schizophrenia: pharmacotherapy and psychotherapy. Baltimore: Williams & Wilkins, 1972.
5. Messier J, Finnerty R, Botvin C, Grinspoon L. A follow-up study of intensively treated chronic schizophrenic patients. Am J Psychiatry 1969; 125: 1123-1127.
6. Gorham DR, Pokorny AD. Effects of a pheno-thiazine and/or group psychotherapy with schizophrenics. Dis Nerv Sys 1964; 25: 77-86.
7. Honigfeld G, Rosenbaum MP, Blumenthal IJ, Lambert HL Roberts AJ. Behavioral improvement in the older schizophrenic patient: drug and social therapies. J Am Geriatr Soc 1965; 8: 57-72.
|
|
|
8. Dvangelakis MG. De-institutionalization of patients. Dis Nerv Sys 1961; 22: 26-32.
9. Rogers CR, Gendlin EG, Kiesler DJ, Traux CB, eds. The therapeutic relationship and its impact: a study of psychotherapy with schizophrenics. Madison: University of Wisconsin Press, 1967.
10. Gunderson JG, Frank AF, Katz HM, Vannicelli ML, Frosch JP, Knapp PH. Effects of psychotherapy in schizophrenia: II. Comparative outcome of two forms of treatment. Schizophr Bull 1984; 10: 564-598.
11. Rosen JN. The treatment of schizophrenic psychoses by direct analytic therapy. Psychiatr Q 1947; 21: 117-119.
12. Rosen JN. Direct analysis: selected papers. New-York: Grune & Stratton, 1953.
13. Karon B, O'Grady P. Intellectual test changes in schizophrenic patients in the first six months of treatment. Psychother Theory Res Pract 1969; 6: 88-96.
14. Karon BP, Vandenbos GR. Experience, medication and the effectiveness of psychotherapy with schizophrenics. Br J Psychiatry 1970; 116: 427-428.
15. Karon BP, Vandenbos GR. The consequences of psychotherapy to schizophrenic patients. Psychother Theory Res Pract 1972; 9; 111-119.
16. Paul GL, Lentz RJ. Psychosocial treatment of chronic mental patients: milieu vs. social learning programs. Cambridge: Harvard University Press, 1977.
17. Paul GL, Tobias LL, Holly BL Maintenance psy-chotropic drugs in the presence of active treatment programs: a " triple-blind" withdrawal study with long-term mental patients. Arch Gen Psychiatry 1972; 27: 106-115.
18. Esterson A, Cooper DG, Laing RD. Results of family-oriented therapy with hospitalized schizophrenics. Br Med J 1965; 2: 1462-1465.
19. Knight A, Hirsch S, Platt SD. Clinical change as a function of brief admission to a hospital in a controlled study using the present state examination. Br J Psychiatry 1980; 137: 170-180.
20. Herz MI, Endicott J, Spitzer RL, Mesnikoff A. Day vs. inpatient hospitalization: a controlled study. Am J Psychiatry 1971; 127: 1371-1382.
21. Herz MI, Endicott J, Spitzer RL Brief hospitalization: a two year follow-up. Am J Psychiatry 1977; 134: 502-507.
22. Glick ID, Hargreaves WA, Drues J, Showstack JA. Short vs. long hospitalization: a prospective con trolled study. IV. One-year follow-up results for schizophrenic patients. Am J Psychiatry 1976; 133: 509-514.
23. Glick ID, Hargreaves WA, Raskin M, Kutner J. Short vs. long hospitalization: a prospective controlled study. I. The preliminary results of a one year follow-up of schizophrenics. Arch Gen Psychiatry 1974; 30: 363-369.
24. Caffey EM, Jones RB, Diamond LS, Burton E, Bo-wen WT. Brief hospital treatment of schizophrenia: early results of a multiple hospital study. Hosp Comm Psychiatry 1968; 19: 282-287.
25. Brown GW, Birley JLT, Wing JK. Influence of family life on the course of schizophrenic disorders: a replication. Br J Psychiatry 1972; 121: 241-258.
26. Leff JP, Wing JK. Trial of maintenance therapy in schizophrenics. Br Med J 1971; 2: 599-604.
27. Vaughn CE, Leff JP. The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed neurotic patients. Br J Psychiatry 1976; 129: 125-137.
|
|
|
28. Vaughn CE, Snyder KS, Jones S, Freeman WB, Fal-loon IRH. Family factors in schizophrenic relapse. Replication in California of British research on expressed emotion. Arch Gen Psychiatry 1984; 41: 1169-1177.
29. Falloon IRH, Boyd JL, McGill CW, Razani J, Moss HB, Gilderman AM. Family management in the prevention of exacerbations of schizophrenia. A controlled study. N Engl J Med 1982; 306: 1437-1440.
30. Goldstein MJ, Rodnick EH, Evans JR, May PRA, Steinberg MR. Drug and family therapy in the aftercare of acute schizophrenics. Arch Gen Psychiatry 1978; 35: 1169-1177.
31. Hogarty GE, Goldberg SC, Schooler NR, Ulrich RE Collaborative Study Group. Drug and sociothe-rapy in the aftercare of schizophrenic padents. II. Two-year relapse rates. Arch Gen Psychiatry 1974; 31: 603-608.
32. Hogarty GE, Schooler NR, Ulrich R, Mussare F, Ferro P, Herron E. Fluphenazine and social therapy in the aftercare of schizophrenic patients. Relapse analyses of a two-year controlled study of fluphenazine decanoate and fluphenazine hydrochloride. Arch Gen Psychiatry 1979; 36: 1283-1294.
33. Hogarty GE, Anderson CM, Reiss DJ, et al. Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. II. Two-year effects of a controlled study on relapse and adjustment. Arch Gen Psychiatry 1991; 48: 340-347.
34. Leff J, Berkowitz R, Shavit N, Strachan A, Glass I, Vaughn C. A trial of family therapy versus a relatives' group for schizophrenia. Two-year follow-up. BrJ Psychiatry 1990; 157: 571-577.
35. Tarrier N, Barrowclough C, Vaughn C, et al. The community management of schizophrenia. A controlled trial of a behavioural intervention with families to reduce relapse. Br J Psychiatry 1988; 153: 532-542.
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