Department of Psychiatry and Psychotherapy, University of Cologne, Germany.
Curr Pharm Des. 2012;18(4):550-7. doi: 10.2174/138161212799316172.
Over the last couple of decades, the treatment of psychoses has much advanced; yet, despite all progress, the individual and societal burden associated with psychosis and particularly schizophrenia has largely remained unchanged. Therefore, much hope is currently placed on indicated prevention as a mean to fight these burdens before they set in. Though the number of studies investigating pharmacological interventions is still limited, encouraging results have been reported from the pioneering trials, despite several methodological limitations. Furthermore, it has become clear that persons characterized by the at-risk criteria are already ill and do not only need preventive intervention, but also treatment. In consequence, outcome criteria have to be broadened to cover the current needs of the patients. As is indicated by a recent study successfully using Omega-3 fatty acids for both purposes, it may be promising to develop and investigate interventions especially for the at-risk state, independent of their effectiveness in manifest disease states. Treatment studies may become promoted by the proposed introduction of a new disorder category into DSM-V. Future prevention studies, however, need to solve the challenge of changing immediate transition rates, demanding for new risk enrichment strategies as a prerequisite for feasible trial designs.
在过去的几十年中，精神疾病的治疗方法有了很大的进步；然而，尽管取得了所有的进步，与精神疾病特别是精神分裂症相关的个人和社会负担在很大程度上仍然没有改变。因此，目前人们非常希望通过有针对性的预防措施来防止这些负担的产生。尽管研究药物干预的研究数量仍然有限，但先驱性试验报告了令人鼓舞的结果，尽管存在一些方法学上的局限性。此外，已经很清楚的是，具有风险特征的人已经患病，他们不仅需要预防干预，还需要治疗。因此，结果标准必须扩大，以涵盖当前患者的需求。最近的一项研究成功地使用欧米伽-3 脂肪酸达到了这两个目的，这表明针对风险状态开发和研究干预措施是有希望的，而不考虑它们在显性疾病状态下的有效性。治疗研究可能会因 DSM-V 中拟议引入的新疾病类别而得到促进。然而，未来的预防研究需要解决改变即时过渡率的挑战，这需要新的风险富集策略作为可行试验设计的前提。
