| Re: Вопрос про психотерапию |
Заголовок темы: Re: Вопрос про психотерапию Отправитель: Arjuna 07.09.2007 15:31:00 Cross, я с вами не соглашусь. Я как-то пробовал расследовать вопрос монотерапии шизофрении "без таблэток" и уже постил в одном из форумов: -------------------------------------------------------- По поводу применения психоаналитического подхода - наткнулся на описание клиники, которая в 1970-е работала только этим методом, без применения лекарств (в статье про исследователя McGlashan'a). Результаты были отрицательные: http://pn.psychiatryonline.org/cgi/content/full/psychnews;42/12/16 Цитата: Analytic Approach Reevaluated In 1975 McGlashan joined Chestnut Lodge in Rockville, Md., where Frieda Fromm-Reichman, Ph.D., and Harold Searles, M.D., among others, had championed a psychoanalytic approach to treating schizophrenia. He would stay there 15 years, and the enormous expenditure of attention to individual lives was unforgettable. "There were a lot of aspects that I came to disagree with, but I think the care that people got there was the best I've ever seen," he said. But McGlashan now believes that for some patients the rigors of an analytic approach were disorganizing. "They fill their lives with what is being created in their brain," he said. "If you rob them of external stimulation by not talking to them about what you think is real, they will fill up the space with delusions and hallucinations and all manner of disorganized thinking." In fact, the futility of those efforts in time became impossible to ignore, and McGlashan undertook an extensive research project to follow long-term outcomes of patients treated at the lodge. The results were dispiriting. In a paper in the June 1984 Archives of General Psychiatry—one of a series of reports on the follow-up study—he reported that of 163 schizophrenia patients followed for an average of 14 years after treatment at the lodge, about two-thirds were functioning marginally or worse. If a measure of scientific integrity is the capacity to test and disprove one's own fondest hypotheses, the paper is a landmark. And it would help redirect efforts at the lodge. "The results were not good news for the medical staff or the director, but they were taken seriously," McGlashan said. "In time things changed, and we began using medications regularly." Rehabilitative services, remedial work, and sheltered workshops were initiated. "It was a belated embracement of community psychiatry," McGlashan recalls. "The staff were initially resistant until they saw that it made a clear difference. Patients didn't get well, but they did get better." Комментарий модератора: Цитата: Исследование действительно масштабное... 163 больных шизофренией лечить психоанализом - не слабо!!! Ухудшение у 2/3 - это закономерный результат (по сути дела естественное течение заболевания)... |
