Early detection of first-episode psychosis: The effect on 1-year outcome
Early detection of first-episode psychosis: The effect on 1-year outcome
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DOI：
10.1093/schbul/sbl005
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发表时间：
2006-10-01
影响因子：
6.6
通讯作者：
McGlashan, Thomas
中科院分区：
文献类型：
--
作者：
Larsen, Tor K.;Melle, Ingrid;McGlashan, Thomas
早期干预被认为可以改善首发精神病的预后，但这尚未得到证实。目的：研究与未早期发现精神病（无艾德）的卫生保健部门相比，早期发现精神病（艾德）的卫生保健部门的1年结局是否更好。设计：一项准实验研究，在2个实验区中有艾德，在2个对照区中无艾德。艾德是通过低门槛的艾德团队和针对公众、学校和初级卫生保健提供者的精神病宣传活动实现的。艾德和非艾德卫生保健区在第一年提供了同等的评估和治疗计划。纳入了281例患者; 88%的患者在1年后重新评估。结果如下：ED区患者（N = 141）基线时未治疗精神病的中位持续时间为5周，而非ED区患者（N = 140）为16周。艾德组和非艾德组在治疗开始后1年的阳性和一般症状、功能总体评估、生活质量、缓解时间和精神病病程方面没有差异。阴性症状的艾德区的结局明显更好。结论：基线时的艾德、无艾德差异在1年时减弱，但阴性症状的差异未减弱，提示在该精神病理学领域进行二级预防。然而，这种可能性需要通过后续行动和复制进行进一步检验。
Early intervention is assumed to improve outcome in first-episode psychosis, but this has not been proven. Objective: To study whether 1-year outcome will be better in a health care sector with early detection (ED) of psychosis compared with sectors with no early detection (no-ED). Design: a quasi-experimental study with ED in 2 experimental sectors and no-ED in 2 control sectors. ED was achieved through low-threshold ED teams and information campaigns about psychosis for the public, schools, and primary health care providers. The ED and no-ED health care areas offered an equivalent assessment and treatment program during the first year. Two hundred and eighty-one patients were included; 88% were reassessed after 1 year. Results: The ED-area patients (N = 141) had a median duration of untreated psychosis of 5 weeks at baseline compared with 16 weeks for patients in the no-ED area (N = 140). Positive and general symptoms, global assessment of functioning, quality of life, time to remission, and course of psychosis at 1 year after the start of treatment were not different between ED and no-ED groups. Outcome was significantly better for the ED area for negative symptoms. Conclusions: The ED, no-ED differences at baseline become attenuated by 1 year but not the difference in negative symptoms, suggesting secondary prevention in this domain of psychopathology. However, this possibility requires further testing by follow-up and replication.