Fraser Richard, Berger Gregor, Killackey Eoin, McGorry Patrick
ORYGEN, Youth Health, Melbourne, Victoria.
Aust Fam Physician. 2006 May;35(5):329-33.
After 18 months of specialist care only about half of all first episode psychosis patients achieve functional recovery, and about 10-20% patients will not respond to initial treatment and have persistent psychotic symptoms. These patients need special attention in order to minimise the burden of disease and prolonged disability.
This article reviews the management of young first episode psychosis patients with incomplete recovery, and focuses on the general practitioner's role, how to deal with treatment resistance, vocational rehabilitation, and other aspects of patient care.
Once the acute episode has been treated, it is important to avoid complacency and address other aspects contributing to a patient's wellbeing including social welfare, physical health and vocational rehabilitation. The prevention of relapse and the psychosocial development of the individual are key in fostering and promoting a healthy lifestyle, leading to improved quality of life. Treatment refractory patients need specialist care.
经过18个月的专科护理，所有首发精神病患者中只有约一半实现功能康复，约10%-20%的患者对初始治疗无反应并持续存在精神病症状。这些患者需要特别关注，以尽量减轻疾病负担和长期残疾。
本文综述了未完全康复的年轻首发精神病患者的管理，重点关注全科医生的作用、如何应对治疗抵抗、职业康复以及患者护理的其他方面。
一旦急性期得到治疗，重要的是避免自满，并关注影响患者福祉的其他方面，包括社会福利、身体健康和职业康复。预防复发和个人的心理社会发展是培养和促进健康生活方式、提高生活质量的关键。治疗难治性患者需要专科护理。
