与标准社区精神卫生团队中首次精神病发作的常规治疗相比,精神病早期干预服务的三年结果——最终结果。
Three year outcomes of an early intervention for psychosis service as compared with treatment as usual for first psychotic episodes in a standard community mental health team - final results.
作者信息
Agius Mark, Shah Samir, Ramkisson Roshelle, Murphy Suzanne, Zaman Rashid
机构信息
Bedfordshire Centre For Mental Health Research in Association with University of Cambridge, Weller Wing Bedford Hospital, Bedford, England.
出版信息
Psychiatr Danub. 2007 Sep;19(3):130-8.
Sixty-two patients who had been treated for three years in an ad-hoc, assertive treatment team for patients who had suffered a first psychotic episode were compared to sixty-two patients who had been followed up after a first psychotic episode in a community mental health team. All patients had suffered a first or early psychotic episode. The main differences between the two teams was that the ad-hoc team was assertive in its approach, offered more structured psycho-education, relapse prevention and psycho-social interventions, and had a policy of using atypical anti-psychotics at the lowest effective dose. There were many differences in outcome measures at the end of three years between the two groups. The EI patients are more likely to be taking medication at the end of three years. They are more compliant with medication. They are more likely to be prescribed Atypical Medication. The EI patients are more likely to have returned to Work or Education. The EI patients are more likely to remain living with their families. They are less likely to suffer depression to the extent of requiring anti-depressants. They appear to commit less suicide attempts. The patients in the EI service also appear to be less likely to suffer relapse and re-hospitalisation, and are less likely to have involuntary admission to hospital. They have systematic relapse prevention plans based on Early Warning Signs. They and their families receive more psycho-education. These indications suggest that the EI patients are at the end of three years better able to manage their illness/vulnerability on their own than the CMHT patients. More patients in the EI group stopped using illicit drugs than in the CMHT group. All the above changes were statistically significant except for the total improvement in employment status and education status, which however approached significance. These results suggest that an ad-hoc Early Intervention Team is more effective than standard Community Mental Health Team in treating psychotic illness.
将62名在专门为首次发作精神病患者设立的积极治疗团队中接受了三年治疗的患者,与62名在社区精神卫生团队中首次发作精神病后接受随访的患者进行了比较。所有患者均经历过首次或早期精神病发作。两个团队之间的主要差异在于,专门团队采取积极主动的治疗方法,提供更具结构性的心理教育、复发预防和心理社会干预,并且有以最低有效剂量使用非典型抗精神病药物的政策。两组在三年结束时的结果测量存在许多差异。接受早期干预(EI)的患者在三年结束时更有可能正在服药。他们对药物治疗的依从性更高。他们更有可能被开具非典型药物。接受EI的患者更有可能重返工作或教育岗位。接受EI的患者更有可能继续与家人同住。他们患抑郁症需要服用抗抑郁药的可能性较小。他们似乎自杀未遂的情况较少。接受EI服务的患者似乎也较不容易复发和再次住院,并且非自愿住院的可能性较小。他们有基于早期预警信号的系统复发预防计划。他们及其家人接受了更多的心理教育。这些迹象表明,在三年结束时,接受EI的患者比社区精神卫生团队(CMHT)的患者更有能力自行管理自己的疾病/脆弱性。与CMHT组相比,EI组中更多患者停止使用非法药物。除就业状况和教育状况的总体改善接近显著水平外,上述所有变化均具有统计学意义。这些结果表明,专门的早期干预团队在治疗精神病性疾病方面比标准的社区精神卫生团队更有效。