A Randomized Controlled Trial of Relapse Prevention Therapy for First-Episode Psychosis Patients
A Randomized Controlled Trial of Relapse Prevention Therapy for First-Episode Psychosis Patients
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DOI：
10.4088/jcp.08m04407
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发表时间：
2009-04-01
影响因子：
5.3
通讯作者：
McGorry, Patrick D.
中科院分区：
文献类型：
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作者：
Gleeson, John F. M.;Cotton, Sue M.;McGorry, Patrick D.
目的：首发精神病患者对急性期治疗有反应。但复发率很高。本研究旨在评估旨在预防第二次精神病发作的心理社会疗法与标准化早期精神病护理的有效性。方法：在澳大利亚早期精神病预防和干预中心和巴旺健康中心进行的随机对照试验中，将预防复发的多模式个人和家庭认知行为疗法与专科早期精神病服务中的标准化病例管理进行了比较。研究对象为2003年11月至2005年5月间首次出现DSM-IV精神障碍的15至25岁患者。主要观察指标为复发次数和首次复发时间。结果：41例首发精神病患者随机分为复发预防治疗组(RPT)和标准化病例管理组(40例)。在7个月的随访中，与常规治疗相比，治疗条件下的复发率显著降低(p=.042)，而RPT条件下的复发时间显著延长(p=.03)。7个月内需要治疗的人数为6人。结论：与标准化的早期精神病病例管理相比，中期结果表明，在专科早期精神病计划中提供RPT在减少早期精神病复发方面是有效的。
Objective: Patients with first-episode psychosis are responsive to acute-phase treatments. but relapse rates are high. This study aimed to evaluate the effectiveness of a psychosocial treatment designed to prevent the second episode of psychosis compared with standardized early psychosis care.Method: In a randomized controlled trial, conducted at the Early Psychosis Prevention and Intervention Centre and Barwon Health, Australia, a multimodal individual and family cognitive-behavioral therapy for relapse prevention was compared with standardized case management within a specialist early psychosis service. Patients aged 15 to 25 years with it first episode of a DSM-IV psychotic disorder were recruited between November 2003 and May 2005. The main outcome measures were the number of relapses and time to first relapse.Results: Forty-one first-episode psychosis patients were randomly assigned to the relapse prevention therapy (RPT) and 40 to standardized case management. At the 7-month follow up, the relapse rate was significantly lower in the therapy condition compared to treatment as usual (p = .042) and time to relapse was significantly longer for the RPT condition (p = .03). The number needed to treat was 6 over 7 months.Conclusions: Interim findings suggest that RPT provided within a specialist early psychosis program was effective in reducing relapse in early psychosis when compared with standardized early psychosis case management.