Pathways to care in subjects at high risk for psychotic disorders - A European perspective
Pathways to care in subjects at high risk for psychotic disorders - A European perspective
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DOI：
10.1016/j.schres.2013.11.031
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发表时间：
2014-02-01
影响因子：
4.5
通讯作者：
Juckel, Georg
中科院分区：
文献类型：
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作者：
von Reventlow, Heinrich Graf;Krueger-Zguerdal, Seza;Juckel, Georg
基于证据的早期精神病预防决策需要对高危受试者的护理途径进行大规模研究。Epos(欧洲精神病预测研究)是一项在四个欧洲国家(芬兰、德国、荷兰和英国)进行的前瞻性、多中心、自然主义的实地研究，旨在获得有关护理途径和获得专门高风险护理的延迟的准确知识。我们的高危样本(n=233)报告平均有2.9次求助接触，从出现相关问题到首次求助接触的平均延迟为72.6周，从初次求助接触到获得专门的高风险护理之间的平均延迟为110.9周。这导致了一种未被认识到的精神病风险的总估计持续时间为31年半。在EPOS欧盟地区，大约90%的护理途径接触者是专业卫生保健部门。在EPOS地区之间，包括早期检测和卫生保健系统在内的通路参数的差异往往非常明显。后来转变为完全精神障碍的高危参与者在最初寻求帮助和接受适当干预之间的延迟时间要长得多。我们的研究强调了在各自的精神健康和卫生保健网络中实施区域适应的早期检测和干预计划的必要性，包括提高公众对早期精神病的认识。(C)2013爱思唯尔B.V.保留所有权利。
Evidence-based decisions on indicated prevention in early psychosis require large-scale studies on the pathways to care in high-risk subjects. EPOS (The European Prediction of Psychosis Study), a prospective multi-center, naturalistic field study in four European countries (Finland, Germany, The Netherlands and England), was designed to acquire accurate knowledge about pathways to care and delay in obtaining specialized high risk care. Our high risk sample (n = 233) reported on average 2.9 help-seeking contacts, with an average delay between onset of relevant problems to initial help-seeking contact of 72.6 weeks, and between initial help-seeking contact and reaching specialized high risk care of 110.9 weeks. This resulted in a total estimated duration of an unrecognized risk for psychosis of 31/2 years. Across EPOS EU regions, about 90% of care pathway contacts were within professional health care sectors. Between EPOS regions, differences in the pathways parameters including early detection and health-care systems were often very pronounced. High-risk participants who later made transition to a full psychotic disorder had significantly longer delays between initial help-seeking and receiving appropriate interventions. Our study underlines the need for regionally adapted implementation of early detection and intervention programs within respective mental health and health care networks, including enhancing public awareness of early psychosis. (C) 2013 Elsevier B.V. All rights reserved.