Lehman Anthony F, Steinwachs Donald M
Department of Psychiatry, University of Maryland, Baltimore 21201, USA.
J Am Acad Psychoanal Dyn Psychiatry. 2003 Spring;31(1):141-54. doi: 10.1521/jaap.31.1.141.21939.
The care of persons with schizophrenia, the prototypical severe mental illness, has been a barometer of mental health care policy for decades. The prevalence, severity, and costs of schizophrenia combine to make this illness a major health problem throughout the world. In 1992, the Agency for Health Care Policy and Research and the National Institute of Mental Health funded the Schizophrenia Patient Outcomes Research Team (PORT) at the University of Maryland School of Medicine and the Johns Hopkins University School of Public Health. The PORT undertook several activities, including a comprehensive review of the empirical literature on the treatment of persons with schizophrenia; development of evidence-based treatment recommendations; description of current treatment practices; and comparison of these current practices to the evidence-based treatment recommendations, using administrative claims data and a survey of persons under treatment for schizophrenia; and dissemination of the treatment recommendations to evaluate impacts on practices. The PORT found that despite considerable evidence for effective treatments for persons with schizophrenia, most patients do not receive an appropriately comprehensive treatment "package." In particular, efficacious psychosocial treatments are highly underutilized.
几十年来，精神分裂症患者（典型的严重精神疾病患者）的护理一直是精神卫生保健政策的晴雨表。精神分裂症的患病率、严重程度和治疗成本，使其成为全球范围内的一个重大健康问题。1992年，医疗保健政策与研究机构以及国立精神卫生研究所资助了马里兰大学医学院和约翰·霍普金斯大学公共卫生学院的精神分裂症患者结局研究团队（PORT）。PORT开展了多项活动，包括对精神分裂症患者治疗的实证文献进行全面综述；制定基于证据的治疗建议；描述当前的治疗实践；利用行政索赔数据和对精神分裂症治疗患者的调查，将这些当前实践与基于证据的治疗建议进行比较；以及传播治疗建议以评估对实践的影响。PORT发现，尽管有大量证据表明精神分裂症患者有有效的治疗方法，但大多数患者并未得到适当全面的治疗“套餐”。特别是，有效的心理社会治疗方法未得到充分利用。
