首发精神病的临床康复
Clinical recovery in first-episode psychosis.
作者信息
Wunderink Lex, Sytema Sjoerd, Nienhuis Fokko J, Wiersma Durk
机构信息
University Medical Center Groningen, University Psychiatric Center (5.21), University of Groningen, 9700 RB Groningen, The Netherlands.
出版信息
Schizophr Bull. 2009 Mar;35(2):362-9. doi: 10.1093/schbul/sbn143. Epub 2008 Nov 5.
Abstract
INTRODUCTION
Generally agreed outcome criteria in psychosis are required to evaluate the effectiveness of new treatment strategies. The aim of this study is to explore clinical recovery in first-episode patients, defined by meeting criteria for both symptomatic and functional remission.
METHOD
In a sample of first-episode patients (N = 125), symptomatic and functional remission during the last 9 months of a 2-year follow-up period were examined, as well as recovery and its predictors.
RESULTS
Half the patients (52.0%) showed symptomatic remission and a quarter (26.4%) functional remission, while one-fifth (19.2%) met both criteria sets and were considered recovered. Recovery was significantly associated with short duration of untreated psychosis and better baseline functioning.
CONCLUSION
Most functionally remitted patients were also symptomatically remitted, while a minority of symptomatically remitted patients were also functionally remitted. Treatment delay may affect chance of recovery.
摘要
引言
需要通用的精神病学疗效标准来评估新治疗策略的有效性。本研究旨在探讨首发患者的临床康复情况，其定义为符合症状缓解和功能缓解的标准。
方法
在一组首发患者样本（N = 125）中，对两年随访期最后9个月的症状缓解和功能缓解情况以及康复情况及其预测因素进行了检查。
结果
一半患者（52.0%）出现症状缓解，四分之一（26.4%）出现功能缓解，而五分之一（19.2%）符合两组标准，被视为康复。康复与未治疗精神病的短病程以及更好的基线功能显著相关。
结论
大多数功能缓解的患者也有症状缓解，而少数症状缓解的患者也有功能缓解。治疗延迟可能会影响康复机会。
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本文引用的文献
1
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2
Guided discontinuation versus maintenance treatment in remitted first-episode psychosis: relapse rates and functional outcome.首发精神病缓解期的指导性停药与维持治疗：复发率及功能转归
J Clin Psychiatry. 2007 May;68(5):654-61. doi: 10.4088/jcp.v68n0502.
3
Assessment of community functioning in people with schizophrenia and other severe mental illnesses: a white paper based on an NIMH-sponsored workshop.精神分裂症及其他严重精神疾病患者的社区功能评估：基于美国国立精神卫生研究所主办研讨会的白皮书
Schizophr Bull. 2007 May;33(3):805-22. doi: 10.1093/schbul/sbl035. Epub 2006 Aug 24.
4
Agreement of a work-capacity assessment with the World Health Organisation International Classification of Functioning, Disability and Health pain sets and back-to-work predictors.工作能力评估与世界卫生组织《国际功能、残疾和健康分类》疼痛集及重返工作岗位预测因素的一致性。
Int J Rehabil Res. 2006 Sep;29(3):183-93. doi: 10.1097/01.mrr.0000210057.06989.12.
5
Predictive validity of proposed remission criteria in first-episode schizophrenic patients responding to antipsychotics.抗精神病药物治疗反应良好的首发精神分裂症患者中，所提出的缓解标准的预测效度。
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6
Treatment delay and response rate in first episode psychosis.首发精神病的治疗延迟与缓解率
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8
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9
Standardized remission criteria in schizophrenia.精神分裂症的标准化缓解标准。
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10
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