Riecher-Rössler A, Gschwandtner U, Borgwardt S, Aston J, Pflüger M, Rössler W
Psychiatric Outpatient Department, University Hospital Basel, Basel, Switzerland.
Acta Psychiatr Scand Suppl. 2006(429):73-80. doi: 10.1111/j.1600-0447.2005.00722.x.
Whereas early detection and therapy of schizophrenic psychoses until some time ago concentrated on frank schizophrenia, during the last years some centres have also started to treat patients even before a clear diagnosis could be established. This paper attempts to discuss if and when this is justified in the light of recent research.
Mini review of literature.
The rationale for early detection and treatment of schizophrenia is based on several observations: diagnosis and treatment of schizophrenia are often seriously delayed. Consequences of the disease are severe already in the early undiagnosed phase of the disorder and early treatment seems to improve the course of the disease. It can therefore be stated quite safely that patients should be treated as early as possible. However, the question of how early has not been sufficiently answered up to now.
We are at the moment in an ethical dilemma between either diagnosing and treating this disorder too late or too early. The only way and prerequisite for solving this dilemma is a more reliable identification of individuals at risk and the beginning disease process.
直到不久前，精神分裂症的早期检测和治疗还集中在明显的精神分裂症上，但在过去几年里，一些中心甚至在尚未明确诊断之前就开始治疗患者。本文试图根据最近的研究来探讨这样做是否合理以及何时合理。
文献综述。
精神分裂症早期检测和治疗的理论依据基于以下几点观察：精神分裂症的诊断和治疗常常严重延迟。在该疾病早期未被诊断阶段，其后果就已很严重，而早期治疗似乎能改善疾病进程。因此，可以相当肯定地说，患者应尽早接受治疗。然而，到目前为止，多早才算早这个问题尚未得到充分解答。
目前我们处于一种伦理困境中，要么对这种疾病诊断和治疗过晚，要么过早。解决这一困境的唯一方法和前提是更可靠地识别有患病风险的个体以及疾病起始过程。
