Hui Christy L M, Chang Wing C, Chan Sherry K W, Lee Edwin H M, Tam Wendy W Y, Lai Dik C, Wong Gloria H Y, Tang Jennifer Y M, Li Frendi W S, Leung Kwok F, McGhee Sarah M, Sham Pak C, Chen Eric Y H
Departments of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region, China.
Early Interv Psychiatry. 2014 Aug;8(3):261-8. doi: 10.1111/eip.12034. Epub 2013 Feb 28.
Psychotic disorders incur substantial long-term burdens to patients and society. Early intervention (EI) during the initial years of psychotic disorders can improve long-term outcome. In Hong Kong, a pilot EI programme (EASY, Early Assessment Service for Young people with psychosis) had been set up since 2001 to serve clients under 25 years of age. Although EASY has been effective in improving outcome, consolidation of early psychosis work requires further development.
The present paper describes a new EI development which targets adult patients with psychosis in Hong Kong. The Jockey Club Early Psychosis (JCEP) project was launched in 2009. Expanding the service to patients above 25 years old, JCEP aims to deliver a territory-wide specialized EI service to adult-onset psychosis patients, to promote public awareness on early psychosis, and to research on the optimal intervention model and duration for early psychosis in a 4-year randomized controlled trial (RCT). Participants were randomly assigned to receive either 4 years of EI service, 2 years of EI service, or 4 years of standard care. Their symptoms, neurocognitive functions, psychosocial well-being and health economics were regularly assessed.
To date, 360 patients were recruited into the RCT, and 740 patients were recruited in a 2-year naturalistic study. Prospective, longitudinal follow-up assessments of these patients are still underway.
JCEP is the first EI project to provide adult early psychosis service in Chinese population. Future data would help to address the optimal duration of EI and its cost-effectiveness. This would also assist regional and international mental health development.
精神障碍给患者和社会带来了巨大的长期负担。在精神障碍发病的最初几年进行早期干预（EI）可以改善长期预后。在香港，自2001年起设立了一个早期干预试点项目（EASY，即青少年精神病早期评估服务），为25岁以下的患者提供服务。尽管EASY在改善预后方面很有效，但早期精神病工作的巩固仍需进一步发展。
本文描述了一项针对香港成年精神病患者的新的早期干预发展项目。赛马会早期精神病项目（JCEP）于2009年启动。JCEP将服务扩展到25岁以上的患者，旨在为成年期发病的精神病患者提供全港范围的专门早期干预服务，提高公众对早期精神病的认识，并在一项为期4年的随机对照试验（RCT）中研究早期精神病的最佳干预模式和持续时间。参与者被随机分配接受4年的早期干预服务、2年的早期干预服务或4年的标准护理。定期评估他们的症状、神经认知功能、心理社会幸福感和健康经济学情况。
迄今为止，360名患者被纳入随机对照试验，740名患者被纳入一项为期2年的自然主义研究。对这些患者的前瞻性纵向随访评估仍在进行中。
JCEP是首个为中国人群提供成年早期精神病服务的早期干预项目。未来的数据将有助于确定早期干预的最佳持续时间及其成本效益。这也将有助于区域和国际精神卫生的发展。
