RECOVERY AFTER INITIAL SCHIZOPHRENIA EPISODE (RAISE)

该最初精神分裂症发作后的恢复（RAISE）倡议旨在通过在疾病的最早阶段进行协调和积极的治疗，从根本上改变精神分裂症的轨迹和预后。 总统的精神卫生新自由委员会呼吁改造美国的精神卫生系统，设想每个精神疾病患者都能康复的未来。也许对这种新观点的最大挑战是精神分裂症，这是一种破坏性的精神疾病，会损害个人以正常方式思考，感受和联系的能力。精神分裂症通常开始于青春期后期或成年早期，从而破坏了人际关系，学术和职业成就，使年轻人为成年人的角色和责任做好准备。精神病的反复发作很常见，多次住院和功能逐渐恶化。 一旦精神分裂症成为一种慢性疾病，不良结局通常是常态。 精神病的第一次发作是精神分裂症过程中一个容易识别的事件，也是一个独特的干预机会。鉴于目前对精神分裂症早期阶段的了解，改变通常与疾病相关的令人沮丧的预后的最佳机会是在精神病首次发作时，在功能能力丧失之前进行积极干预。RAISE计划将通过支持与美国精神卫生系统相关的精神分裂症早期干预模型的开发、完善、部署和测试来测试这一假设，从这个意义上说，如果发现它在真实的世界环境中有效，并且相对具有成本效益，它可以在人口水平上可行地部署。 RAISE将把精神分裂症治疗的重点从管理终末期疾病转移到早期和积极的治疗上。这里的目标是指出预防，在疾病的早期预防症状和功能恶化。 RAISE代表了一种协调的努力，旨在设计和测试一种有效的早期精神分裂症干预措施，这种干预措施可以广泛实施，即，人口规模从最早的发展阶段，这种干预措施将包括必要的功能，在我们的社区快速传播，采用和实施，从而促进从研究到实践的过渡。最终目标是通过工程学快速采用和广泛实施有效的治疗方案来改变美国目前治疗精神分裂症的范式。RAISE是这一过程中必要的第一步，将有助于确定是否早期识别和干预计划位于社区为基础的设置可以减缓或停止精神分裂症的临床和功能恶化。

The ¿Recovery After an Initial Schizophrenia Episode¿ (RAISE) initiative seeks to fundamentally change the trajectory and prognosis of schizophrenia through coordinated and aggressive treatment in the earliest stages of illness. The President's New Freedom Commission on Mental Health calls for transformation of the mental health system in the United States, envisioning ¿a future when everyone with a mental illness will recover.¿ Perhaps the greatest challenge to this new vision is schizophrenia, a devastating mental illness that impairs an individual¿s ability to think, feel, and relate in a normal manner. Schizophrenia typically begins in late adolescence or early adulthood, thus derailing the interpersonal, academic, and vocational achievements that prepare a young person for adult roles and responsibilities. Recurrent episodes of psychosis are common, with multiple hospitalizations and gradual worsening of functioning. Once schizophrenia becomes established as a chronic illness, poor outcome is generally the norm. The first episode of psychosis represents a readily identifiable event in the course of schizophrenia, and a unique opportunity for intervention. Given current knowledge of the earliest phases of schizophrenia, the best chance for altering the discouraging prognosis commonly associated with the illness is to intervene aggressively at the first episode of psychosis, before functional abilities are lost. The RAISE initiative will test this hypothesis by supporting the development, refinement, deployment, and testing of an early intervention model for schizophrenia that is relevant to the U.S. mental health system, in the sense that ¿ if found to be effective in real world settings and relatively cost-effective ¿ it could be deployed feasibly at a population level. RAISE will shift the focus of schizophrenia treatment away from managing end stage disease to early and aggressive treatment. The goal here is indicated prevention that pre-empts symptomatic and functional deterioration in the early years of illness. RAISE represents a coordinated effort to design and test an effective intervention for early phase schizophrenia that can be implemented on a wide, i.e., population-level, scale. From the earliest stages of development, this intervention will incorporate necessary features for rapid dissemination, adoption, and implementation in our communities, thus facilitating the transition from research to practice. The ultimate goal is to transform the current paradigm for treating schizophrenia in the United States by engineering rapid adoption and implementation of an effective treatment package on a broad scale. RAISE is a necessary first step in this process and will help to determine whether early identification and intervention programs situated in community-based settings can slow or halt clinical and functional deterioration in schizophrenia.