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早发性精神分裂症的治疗:近期趋势、挑战及未来考量

Treatment of early onset schizophrenia: recent trends, challenges and future considerations.

作者信息

Vyas Nora S, Gogtay Nitin

机构信息

Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health Bethesda, MD, USA.

出版信息

Front Psychiatry. 2012 Apr 2;3:29. doi: 10.3389/fpsyt.2012.00029. eCollection 2012.

Abstract

Early onset schizophrenia (onset before adulthood) is a rare, severe, and chronic form of schizophrenia. The clinical presentation of schizophrenia at this unusually early age of onset has been associated with premorbid developmental abnormalities, poor response to neuroleptic treatment, greater admission rates, and poor prognosis. This is a brief, condensed review of current treatment strategies for the early onset population highlighting the need for novel treatment strategies for these generally treatment-refractory cases. Based on the current literature, second-generation antipsychotics remain the mainstay of treatment, although current medications provide suboptimal response at best. Based on the adult literature, combining antipsychotic treatment with psychotherapeutic intervention may be a more comprehensive treatment strategy. Indeed, early detection, identification of relevant biomarkers, coupled with advancing knowledge of the neurochemical and neuroanatomic pathways may help design informed and novel treatment strategies.

摘要

早发性精神分裂症(成年前发病)是一种罕见、严重的慢性精神分裂症形式。在这个异常早的发病年龄出现的精神分裂症临床表现与病前发育异常、对抗精神病药物治疗反应不佳、更高的住院率以及不良预后相关。这是一篇简短的综述,总结了针对早发性人群的当前治疗策略,强调了针对这些通常难治性病例采用新治疗策略的必要性。根据当前文献,第二代抗精神病药物仍然是治疗的主要手段,尽管目前的药物充其量只能提供次优反应。根据成人文献,将抗精神病药物治疗与心理治疗干预相结合可能是一种更全面的治疗策略。事实上,早期检测、识别相关生物标志物,再加上对神经化学和神经解剖途径的深入了解,可能有助于设计明智且新颖的治疗策略。

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