Morrison Anthony P, French Paul, Parker Sophie, Roberts Morwenna, Stevens Helen, Bentall Richard P, Lewis Shôn W
Department of Psychology, University of Manchester, Coupland Street, Manchester M13 9PL, UK.
Schizophr Bull. 2007 May;33(3):682-7. doi: 10.1093/schbul/sbl042. Epub 2006 Sep 14.
There have been recent advances in the ability to identify people at high risk of developing psychosis. This has led to interest in the possibility of preventing the development of psychosis. A randomized controlled trial compared cognitive therapy (CT) over 6 months with monthly monitoring in 58 patients meeting criteria for ultrahigh risk of developing a first episode of psychosis. Participants were followed up over a 3-year period. Logistic regression demonstrated that CT significantly reduced likelihood of being prescribed antipsychotic medication over a 3-year period, but it did not affect transition to psychosis defined using the Positive and Negative Syndrome Scale (PANSS) or probable Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis. However, exploratory analyses revealed that CT significantly reduced the likelihood of making progression to psychosis as defined on the PANSS over 3 years after controlling for baseline cognitive factors. Follow-up rate at 3 years was 47%. There appear to be enduring benefits of CT over the long term, suggesting that it is an efficacious intervention for people at high risk of developing psychosis.
近期在识别有患精神病高风险人群的能力方面取得了进展。这引发了人们对预防精神病发展可能性的兴趣。一项随机对照试验将6个月的认知疗法（CT）与对58名符合首次发作精神病超高风险标准的患者进行每月监测进行了比较。参与者随访了3年。逻辑回归表明，CT在3年期间显著降低了开具抗精神病药物的可能性，但它并未影响使用阳性和阴性症状量表（PANSS）或《精神障碍诊断与统计手册》第四版可能诊断定义的向精神病的转变。然而，探索性分析显示，在控制基线认知因素后，CT在3年期间显著降低了按照PANSS定义发展为精神病的可能性。3年时的随访率为47%。CT似乎有长期的持久益处，表明它是对有患精神病高风险人群的一种有效干预措施。
