Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital Department of Psychiatry, Queen Mary Hospital, Pokfulam Road, Hong Kong.
Early Interv Psychiatry. 2011 Nov;5(4):315-23. doi: 10.1111/j.1751-7893.2011.00279.x. Epub 2011 Jul 4.
Although phase-specific early intervention for first-episode psychosis has been implemented in many different parts of the world, limited medium-term outcome data are available in non-Western populations with relatively low mental health resources. The study aimed to determine the effectiveness of phase-specific early intervention in first-episode psychosis.
In this cohort study, we compared the 3-year outcome of 700 first-episode psychosis patients who received phase-specific early intervention with that of 700 patients matched for age, sex and diagnosis who received standard psychiatric care prior to early intervention. Using a structured data acquisition procedure, we determined functional outcome, symptom levels, relapse, recovery, suicidal behaviour and service utilization from clinical records.
Patients in the early intervention group had longer full-time employment or study (P<0.001), fewer days of hospitalization (P<0.001), less severe positive symptoms (P=0.006), less severe negative symptoms (P =0.001), fewer suicides (P=0.009) and fewer disengagements (P=0.002) than the historical control group. Additionally, more patients in the early intervention group experienced a period of recovery (P=0.001), but the two groups had similar rates of relapse (P=0.08) and durations of untreated psychosis (P=0.72).
The 3-year outcome in phase-specific early intervention compared favourably with that of standard psychiatric care, particularly with respect to functional outcome and reduction in hospitalizations, suicides and disengagements. However, intervention did not appear to reduce the rate of relapse.
尽管在世界许多不同地区都实施了针对首发精神病的阶段性早期干预，但在精神卫生资源相对较少的非西方人群中，仅有有限的中期结局数据。本研究旨在确定针对首发精神病的阶段性早期干预的有效性。
在这项队列研究中，我们比较了接受阶段性早期干预的 700 例首发精神病患者与在早期干预前接受标准精神科护理的 700 例年龄、性别和诊断相匹配的患者的 3 年结局。通过结构化数据采集程序，我们从临床记录中确定了功能结局、症状水平、复发、康复、自杀行为和服务利用情况。
早期干预组患者的全职工作或学习时间更长（P<0.001），住院天数更少（P<0.001），阳性症状更轻（P=0.006），阴性症状更轻（P=0.001），自杀事件更少（P=0.009），脱离治疗更少（P=0.002），与历史对照组相比。此外，早期干预组更多患者经历了康复期（P=0.001），但两组的复发率（P=0.08）和未治疗精神病持续时间（P=0.72）相似。
与标准精神科护理相比，阶段性早期干预的 3 年结局更好，特别是在功能结局和减少住院、自杀和脱离治疗方面。然而，干预似乎并未降低复发率。
