New Targets for Prevention of Schizophrenia: Is It Time for Interventions in the Premorbid Phase?
New Targets for Prevention of Schizophrenia: Is It Time for Interventions in the Premorbid Phase?
复制标题
预防精神分裂症的新目标：现在是在病前阶段进行干预的时候了吗？
DOI：
10.1093/schbul/sbv050
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发表时间：
2015
影响因子：
6.6
通讯作者：
Nordentoft,Merete
中科院分区：
文献类型：
--
作者：
Seidman,LarryJ;Nordentoft,Merete
许多影响汇聚在一起，使这个特别主题问题及时：“一个新的方向：考虑发展敏感目标的早期干预精神分裂症”。这些因素包括：1.对精神病发病前发育脆弱性的大量了解，特别是关于精神分裂症; 2.在精神病的临床高风险阶段的干预措施中出现的有希望的结果; 3.认识到发育期是发育脱轨的相对较晚阶段。这些因素加在一起导致了一种观点，即更早的干预是必要的。本文简要总结了文章组成的特殊主题，包括新的数据，早期神经认知发展，提出的潜在目标，在发病前的时期，早在怀孕，和伦理挑战的心理社会和心理药理学干预。这些思想实验必须经过实证检验，并克服各种干预措施所带来的伦理挑战，这些干预措施包括相对低风险的支持性心理社会干预措施和高风险的实验性药理干预措施。所有提出的干预措施都需要仔细研究伦理、安全性、潜在的耻辱感、可行性、有效性和耐受性，以及对所涉人员的意义。
A number of influences have converged that make this Special Theme Issue timely: “A New Direction: Considering Developmentally Sensitive Targets for Very Early Intervention in Schizophrenia”. These factors include: 1. the substantial knowledge about premorbid developmental vulnerabilities to psychosis, especially regarding schizophrenia; 2. the promising results emerging from interventions during the clinical high-risk (CHR) phase of psychosis and; 3. the recognition that the CHR period is a relatively late phase of developmental derailment. These factors have together led to a perspective that even earlier intervention is warranted. This paper briefly summarizes the articles comprising the Special Theme including new data on early neurocognitive development, proposed potential targets for psychosocial and psychopharmacological interventions during the premorbid period as early as pregnancy, and ethical challenges. These thought experiments must be empirically tested, and the ethical challenges overcome as posed by the various interventions, which range from relatively low risk, supportive, psychosocial to higher risk, experimental, pharmacological interventions. All of the interventions proposed require careful study of ethics, safety, potential stigma, feasibility, efficacy and tolerability, and the meaning to the people involved.