Gleeson John, Larsen T K, McGorry Patrick
ORYGEN Youth Health, Parkville, VIC, Australia.
J Am Acad Psychoanal Dyn Psychiatry. 2003 Spring;31(1):229-45. doi: 10.1521/jaap.31.1.229.21933.
This article aims to overview a broad range of psychosocial treatments for first-episode psychosis, and for the prodromal phase (or so-called at-risk mental state)--the period preceding the first acute episode (Yung and McGorry, 1996). Firstly, an introduction to the empirically based rationale for early intervention in first-episode psychosis is provided. This is followed by a selective review of individual psychotherapies for early psychosis, which then proceeds to a discussion of family-based interventions for first-episode families and the role of group programs. Next, the role of psychological interventions within the newly emerging indicated preventive approach (Mrazek and Haggerty, 1994) for at-risk mental state is examined before some illustrative case material is presented. It is concluded that integrated psychosocial interventions for first-episode psychosis and for prodrome are newly emerging, innovative fields that offer some preventive opportunities. These opportunities, combined with some initial outcome data, warrant continuing research and clinical innovation.
本文旨在概述针对首发精神病以及前驱期(即所谓的高危精神状态)——首次急性发作之前的时期(Yung和McGorry,1996年)的广泛社会心理治疗方法。首先,介绍基于实证的首发精神病早期干预的理论依据。接下来是对早期精神病个体心理治疗的选择性综述,然后讨论针对首发精神病患者家庭的家庭干预以及团体项目的作用。接着,在呈现一些说明性案例材料之前,考察心理干预在针对高危精神状态的新出现的指示性预防方法(Mrazek和Haggerty,1994年)中的作用。得出的结论是,针对首发精神病和前驱期的综合社会心理干预是新出现的、创新的领域,提供了一些预防机会。这些机会,结合一些初步的结果数据,值得持续的研究和临床创新。