Canadian Treatment Guidelines for Individuals at Clinical High Risk of Psychosis
Canadian Treatment Guidelines for Individuals at Clinical High Risk of Psychosis
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DOI：
10.1177/0706743717719895
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发表时间：
2017-09-01
影响因子：
4
通讯作者：
Remington, Gary
中科院分区：
文献类型：
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作者：
Addington, Jean;Addington, Donald;Remington, Gary
目的：处于精神病临床高危状态的年轻人经常寻求帮助，并有明显的痛苦和功能障碍。对这一人群的评估和治疗指南有限。该指南的目的是为这一高危人群制定治疗建议。方法：对已发表的慢性肾功能衰竭指南进行系统搜索。对所有现有的精神分裂症治疗指南进行了审查，以确定中国疾病控制与预防中心的个体治疗指南。被采纳的建议主要来自欧洲精神病学协会(EPA)关于精神病临床高危状态早期干预的指南和2014年国家卫生与护理卓越研究所(NICE)关于CHR精神病患者治疗和管理的指南。结果：在描述了指南的制定过程后，根据证据质量、是否适合加拿大医疗保健系统和临床专家共识，制定了9项建议。结论：该领域专家的评估是第一个建议。建议采用阶段性治疗方法，将心理治疗作为一线治疗，药物治疗保留给成年人、对心理干预没有反应的人和有更严重症状的人。
Objective: Young people who are at clinical high risk (CHR) of developing psychosis are often help seeking and have significant distress and dysfunction. There are limited guidelines for the assessment and treatment for this population. The aim of this guideline was to develop treatment recommendations for this at-risk group.Method: A systematic search was conducted for published guidelines for CHR. All current guidelines for schizophrenia were reviewed for treatment guidelines on individuals at CHR. The recommendations adopted were primarily drawn from the European Psychiatric Association (EPA) guidance on the early intervention in clinical high-risk states of psychoses and the 2014 National Institute for Health and Care Excellence (NICE) guidelines on the treatment and management of those at CHR for psychosis.Results: After the guideline development process described, 9 recommendations were developed based on the quality of evidence, appropriateness for the Canadian health care system, and clinical expert consensus.Conclusions: Assessment by an expert in the field was the first recommendation. It was recommended that treatment follow a staged approach with psychological treatments being the first-line treatment and pharmacotherapy reserved for adults, those who did not respond to psychological interventions, and those who had more severe symptoms.