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平衡治疗安全性与疗效以改善精神分裂症的临床和经济结局:临床概述

Balancing therapeutic safety and efficacy to improve clinical and economic outcomes in schizophrenia: a clinical overview.

作者信息

Javitt Daniel C

出版信息

Am J Manag Care. 2014 Jun;20(8 Suppl):S160-5.

Abstract

Affecting up to 1% of the global population, schizophrenia is a chronic, disabling psychiatric disorder that has profound effects on patients, families, and caretakers due to its tremendous personal, social, and economic burdens. Schizophrenia commonly presents during late adolescence and early adulthood, and although its onset may be abrupt, the majority of patients experience a slow and gradual development of various clinical signs and symptoms. In addition to psychotic symptoms that may alter one's perception, thoughts, affect, and behavior, schizophrenia is associated with increased morbidity and mortality, reduced life expectancy, and higher risks of homelessness and unemployment. Although much research has been conducted on schizophrenia, the exact etiology of the disease remains unclear and is likely multifactorial, and evidence has suggested that neuroanatomical alterations and neurotransmitter abnormalities contribute to the disease's pathophysiology. It is essential to remember that schizophrenia is a chronic disease that requires long-term treatment. While there are currently no definitive diagnostic tests for schizophrenia, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria should be used to guide proper diagnosis and identification. Further research and an improved understanding of the pathophysiological basis of schizophrenia may drive more effective treatment options and improved patient outcomes for this complex and challenging disease.

摘要

精神分裂症影响着全球多达1%的人口,是一种慢性致残性精神障碍,因其巨大的个人、社会和经济负担,对患者、家庭和护理人员都有深远影响。精神分裂症通常在青春期晚期和成年早期出现,虽然其发病可能突然,但大多数患者会经历各种临床体征和症状的缓慢渐进发展。除了可能改变一个人的感知、思维、情感和行为的精神病性症状外,精神分裂症还与发病率和死亡率增加、预期寿命缩短以及无家可归和失业风险较高有关。尽管对精神分裂症已经进行了大量研究,但该疾病的确切病因仍不清楚,可能是多因素的,并且有证据表明神经解剖学改变和神经递质异常促成了该疾病的病理生理学。必须记住,精神分裂症是一种需要长期治疗的慢性疾病。虽然目前没有针对精神分裂症的确切诊断测试,但应使用《精神疾病诊断与统计手册》第五版标准来指导正确的诊断和识别。对精神分裂症病理生理基础的进一步研究和更好理解可能会推动针对这种复杂且具有挑战性的疾病产生更有效的治疗选择并改善患者预后。

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