Rangaswamy T, Mangala R, Mohan G, Joseph J, John S
Schizophrenia Research Foundation (India), R/7A North Main Road, Anna Nagar (West Extension), Chennai, India.
East Asian Arch Psychiatry. 2012 Sep;22(3):94-9.
There have been very few studies of first-episode psychoses or early intervention programmes in India. This paper describes a pilot intervention programme for first-episode psychosis at the Schizophrenia Research Foundation, India.
A total of 47 patients with the first episode of psychosis were followed up for 2 years. Based on the Positive and Negative Syndrome Scale for schizophrenia and Global Assessment of Functioning Scale scores, the data from 2 groups of patients, those who had remission and those who did not, were identified and compared. Assessments done at 3, 6, 12 and 24 months after recruitment enabled computation of time to achieve remission.
Complete data were available for 38 patients (28 patients in remission group and 10 patients in non-remission group) at 2 years. Baseline scores were not significantly different between the groups. In the remission group, more than 50% attained maximal improvement at 3 months, another 30% at 1 year, and the remaining 20% at 2 years. Maximal reduction in the mean Positive and Negative Syndrome Scale score was seen between 3 and 6 months after recruitment.
With regular treatment, most patients with early psychosis achieve remission within 2 years. Negative symptoms persisting for longer than 6 months could be an indicator of long-term outcome. Early intervention is feasible and effective in developing countries.
在印度，针对首发精神病或早期干预项目的研究非常少。本文描述了印度精神分裂症研究基金会开展的一项首发精神病试点干预项目。
共有47例首发精神病患者接受了为期2年的随访。根据精神分裂症的阳性和阴性症状量表以及功能总体评定量表评分，对两组患者的数据进行了识别和比较，这两组患者分别为病情缓解组和未缓解组。在招募后3、6、12和24个月进行的评估使得能够计算出达到缓解的时间。
2年后有38例患者（缓解组28例，未缓解组10例）获得了完整数据。两组之间的基线评分无显著差异。在缓解组中，超过50%的患者在3个月时达到最大改善，另有30%在1年时达到，其余20%在2年时达到。在招募后3至6个月期间，阳性和阴性症状量表的平均得分出现最大程度的降低。
通过正规治疗，大多数早期精神病患者在2年内可实现缓解。阴性症状持续超过6个月可能是长期预后的一个指标。早期干预在发展中国家是可行且有效的。
