Reduction in incidence of hospitalizations for psychotic episodes through early identification and intervention.
Reduction in incidence of hospitalizations for psychotic episodes through early identification and intervention.
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DOI：
10.1176/appi.ps.201300336
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发表时间：
2014-10
期刊：
影响因子：
--
通讯作者：
McKeague IW
中科院分区：
文献类型：
--
作者：
McFarlane WR;Susser E;McCleary R;Verdi M;Lynch S;Williams D;McKeague IW
本研究测试了一个社区范围的早期识别和干预系统，以预防精神病的发作，是否减少了精神病住院的发生率。波特兰识别和早期转诊（PIER）项目于2001年启动。专业人员在各种教育、卫生和精神卫生环境中确定了12-35岁的青年和青壮年。PIER工作人员评估，确认精神病风险，并为符合条件和同意的年轻人提供24个月的治疗（N=148）。首次发作精神病的每月住院率是识别和干预效果的结局指标。在缅因州的实验区和城市聚集区，对项目开始接受转诊之前和之后的录取率进行了比较。采用ARIMA模型评价效果。基于ARIMA模型，大波特兰地区精神病住院率显著下降了26% （95% ci， -64%至-11%）。相反，在城市控制区，它增加了8% （95% C.I. -5%至+36%）。包括控制区域的增加，实际与预期的差异（-26% -8%）为-34%。这种变化在非情感-非精神分裂症障碍中最大。PIER表明，在人群范围内进行早期识别是可行的。在中等城市，预防性干预可以降低精神病初次住院率。该研究由缅因州医学中心机构审查委员会审查和批准，并在ClinicalTrials.gov （NCT01597141）上注册。所有研究对象在参与前均给予知情同意。
This study tested whether the incidence of hospitalization for psychosis was reduced by a community-wide system of early identification and intervention to prevent onset of psychosis. The Portland Identification and Early Referral (PIER) program was initiated in 2001. Youth and young adults ages 12-35 were identified by professionals in a wide variety of educational, health and mental health settings. PIER staff assessed, confirmed risk for psychosis and provided treatment for 24 months to eligible and consenting young people (N=148). The monthly rate of hospital admissions for first episode psychosis was the outcome measure for efficacy of identification and intervention. Admission rates before and after the program began accepting referrals were compared, both in the experimental area and in aggregated urban areas of Maine. ARIMA models were used to assess the effect. Based on ARIMA models, the rate of hospitalized psychosis decreased significantly by 26% (95% C.I., -64% to -11%) in the Greater Portland area. Conversely, it increased by 8% (95% C.I. -5% to +36%) in the Urban Control area. Including increases in the control area, the actual vs. expected difference (-26% -8%) was -34%. The change was largest for non-affective-non-schizophrenic Disorders. PIER demonstrated that population-wide early identification is feasible. Preventive intervention can reduce rates of initial hospitalizations for psychosis in a mid-sized city. The study was reviewed and approved by the Maine Medical Center Institutional Review Board and registered at ClinicalTrials.gov (NCT01597141). All research subjects gave informed consent prior to participating.
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影响因子：
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作者：
Amminger, G. Paul;Schafer, Miriam R.;Berger, Gregor E.
通讯作者：
Berger, Gregor E.
影响因子：
--
作者：
Klosterkötter, J;Hellmich, M;Schultze-Lutter, F
通讯作者：
Schultze-Lutter, F
影响因子：
--
作者：
Kirkbride, JB;Fearon, P;Jones, PB
通讯作者：
Jones, PB
精神病高风险状态：全面的最新评论。
影响因子：
25.8
作者：
Fusar-Poli, Paolo;Borgwardt, Stefan;Bechdolf, Andreas;Addington, Jean;Riecher-Rossler, Anita;Schultze-Lutter, Frauke;Keshavan, Matcheri;Wood, Stephen;Ruhrmann, Stephan;Seidman, Larry J.;Valmaggia, Lucia;Cannon, Tyrone;Velthorst, Eva;De Haan, Lieuwe;Cornblatt, Barbara;Bonoldi, Ilaria;Birchwood, Max;McGlashan, Thomas;Carpenter, William;McGorry, Patrick;Klosterkotter, Joachim;McGuire, Philip;Yung, Alison
通讯作者：
Yung, Alison
影响因子：
5.3
作者：
McGorry, Patrick D.;Nelson, Barnaby;Yung, Alison R.
通讯作者：
Yung, Alison R.