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早期干预服务、认知行为疗法和家庭干预在早期精神病中的应用:系统评价。

Early intervention services, cognitive-behavioural therapy and family intervention in early psychosis: systematic review.

机构信息

National Collaborating Centre for Mental Health, Royal College of Psychiatrists' Research and Training Unit, Standon House, 21 Mansell Street, London E1 8AA, UK.

出版信息

Br J Psychiatry. 2010 Nov;197(5):350-6. doi: 10.1192/bjp.bp.109.074526.

Abstract

BACKGROUND

Early intervention services for psychosis aim to detect emergent symptoms, reduce the duration of untreated psychosis, and improve access to effective treatments.

AIMS

To evaluate the effectiveness of early intervention services, cognitive-behavioural therapy (CBT) and family intervention in early psychosis.

METHOD

Systematic review and meta-analysis of randomised controlled trials of early intervention services, CBT and family intervention for people with early psychosis.

RESULTS

Early intervention services reduced hospital admission, relapse rates and symptom severity, and improved access to and engagement with treatment. Used alone, family intervention reduced relapse and hospital admission rates, whereas CBT reduced the severity of symptoms with little impact on relapse or hospital admission.

CONCLUSIONS

For people with early psychosis, early intervention services appear to have clinically important benefits over standard care. Including CBT and family intervention within the service may contribute to improved outcomes in this critical period. The longer-term benefits of this approach and its component treatments for people with early and established psychosis need further research.

摘要

背景

精神病的早期干预服务旨在发现早期症状,减少未治疗精神病的持续时间,并改善获得有效治疗的机会。

目的

评估早期干预服务、认知行为疗法(CBT)和家庭干预在早期精神病中的有效性。

方法

对早期干预服务、CBT 和家庭干预治疗早期精神病患者的随机对照试验进行系统评价和荟萃分析。

结果

早期干预服务降低了住院率、复发率和症状严重程度,并改善了治疗的可及性和参与度。单独使用时,家庭干预降低了复发和住院率,而 CBT 降低了症状严重程度,但对复发或住院率没有影响。

结论

对于早期精神病患者,早期干预服务似乎比标准护理具有重要的临床益处。在服务中纳入 CBT 和家庭干预可能有助于改善这一关键时期的结局。这种方法及其在早期和已确立的精神病患者中的组成治疗的长期益处需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e21/2966501/b3748e7b14b5/351f1c.jpg

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