EPPIC: An evolving system of early detection and optimal management
EPPIC: An evolving system of early detection and optimal management
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DOI：
10.1093/schbul/22.2.305
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发表时间：
1996-01-01
影响因子：
6.6
通讯作者：
Jackson, HJ
中科院分区：
文献类型：
--
作者：
McGorry, PD;Edwards, J;Jackson, HJ
精神障碍发作时的早期干预是一个极具吸引力的理论概念，正受到越来越多的国际关注。在实践中，它相当于首先决定什么时候可以说精神障碍已经开始，然后在尽可能早的时候提供潜在的有效治疗。第二个要素涉及确保这一干预措施成为这一疾病阶段的最佳做法，而不仅仅是将为疾病后期和更长期患病的亚群制定的标准治疗方法转化为标准治疗方法。此外，它还意味着确保将这一最佳实践模式真正交付给患者和家属。这些因素对结果的相对重要性尚未确定。这篇文章概述了早期精神病预防性干预的框架，基于最初在第一代模型中获得的十多年经验。在经历了一段漫长的孕期后，早期精神病预防和干预中心(EPPIC)的诞生遵循了这一经验，这是一种以支持预防任务的多个临床焦点为目标的综合“现实世界”护理模式。报告的数据说明了我们地区治疗延迟的地形和影响，并给出了EPPIC模型的初步评估结果。当第二代模型与第一代模型对比时，第二代模型在症状和功能结果方面显示出显著的改善。讨论了这些发现的含义和未来的发展。
Early intervention at the onset of psychotic disorders is a highly attractive theoretical notion that is receiving increasing international interest. In practical terms, it amounts to first deciding when a psychotic disorder can be said to have commenced and then offering potentially effective treatment at the earliest possible point. A second element involves ensuring that this intervention constitutes best practice for this phase of illness and is not merely the translation of standard treatments developed for later stages and the more persistently ill subgroups of the disorder. Furthermore, it means ensuring that this best practice model is actually delivered to patients and families. The relative importance of these elements in relation to outcome has not yet been established. This article outlines a framework for preventive intervention in early psychosis, based on more than a decade of experience initially gained within a first-generation model. This experience has been followed, after a prolonged gestation, by the birth of the Early Psychosis Prevention and Intervention Centre (EPPIC), a comprehensive ''real-world'' model of care targeting the multiple clinical foci underpinning the preventive task. Data are reported to illustrate the topography and impact of delay in treatment in our regional setting, and the results of an initial evaluation of the EPPIC model are presented. The latter demonstrate a significant improvement in symptomatic and functional outcome when the second-generation model is contrasted with the first. The implications of these findings and future developments are discussed.