Patton George C, Hetrick Sarah E, McGorry Patrick
Centre for Adolescent Health, Murdoch Childrens Research Institute, Royal Children's Hospital, University of Melbourne, Australia.
Curr Opin Psychiatry. 2007 Jul;20(4):319-24. doi: 10.1097/YCO.0b013e3281eb906d.
Many psychiatric disorders have their highest first-onset rates in adolescence and young adulthood. We summarize recent work indicating where interventions are most needed and effective. We also review the literature that examines the scope for reorienting mental health services to meet the needs of adolescents and young adults.
The continuities between youth onset and later life disorders, as well as later social adjustment, have become clearer. Emotional disorders that persist or recur during the teens have the greatest effect on future mental health. To date, service systems, even in the developed world, cater poorly for youth with mental disorders. Intervention studies demonstrate the short-term benefits of intensive multidisciplinary intervention for early psychosis. There are few data concerning the benefit of early intervention for other disorders. Long-term benefits for early intervention for any condition are unknown. Youth streams of psychiatric care have developed for early-onset psychotic disorders.
An increasing understanding of the high prevalence and longer-term effects of youth onset mental disorders has not yet been adequately matched by intervention research or the evaluation of different models of mental health service delivery.
许多精神疾病在青少年期和青年期的首次发病几率最高。我们总结了近期的研究成果,指出了最需要干预且干预有效的领域。我们还回顾了相关文献,这些文献探讨了调整心理健康服务方向以满足青少年和青年需求的可能性。
青少年期发病与成年后期疾病以及后期社会适应之间的连续性变得更加清晰。青少年时期持续或复发的情绪障碍对未来心理健康影响最大。迄今为止,即使在发达国家,服务体系对患有精神疾病的青少年的照顾也很不足。干预研究表明,强化多学科干预对早期精神病有短期益处。关于早期干预对其他疾病的益处的数据很少。早期干预对任何疾病的长期益处尚不清楚。针对早发性精神障碍,已形成了青少年精神病护理流程。
对青少年期发病的精神障碍的高患病率和长期影响的认识不断增加,但干预研究或对不同心理健康服务提供模式的评估尚未与之充分匹配。