改善加拿大温哥华早期精神病干预项目中的代谢和心血管健康。

Improving metabolic and cardiovascular health at an early psychosis intervention program in vancouver, Canada.

机构信息

Faculty of Medicine, University of British Columbia , Vancouver, BC , Canada ; Early Psychosis Intervention Program, Vancouver Coastal Health , Vancouver, BC , Canada.

Faculty of Medicine, University of British Columbia , Vancouver, BC , Canada.

出版信息

Front Psychiatry. 2014 Sep 5;5:105. doi: 10.3389/fpsyt.2014.00105. eCollection 2014.

Abstract

Psychotic disorders most commonly appear during the late teenage years and early adulthood. A focused and rapid clinical response by an integrated health team can help to improve the quality of life of the patient, leading to a better long-term prognosis. The Vancouver Coastal Health early psychosis intervention program covers a catchment area of approximately 800,000 people in the cities of Vancouver and Richmond, Canada. The program provides a multidisciplinary approach to supporting patients under the age of 30 who have recently experienced first-break psychosis. The program addresses the needs of the treatment environment, medication, and psychological therapies. A critical part of this support includes a program to specifically improve patients' physical health. Physical health needs are addressed through a two-pronged, parallel approach. Patients receive routine metabolic health assessments during their first year in the program, where standard metabolic parameters are recorded. Based on the results of clinical interviews and laboratory tests, specific actionable interventions are recommended. The second key strategy is a program that promotes healthy lifestyle goal development. Patients work closely with occupational therapists to develop goals to improve cardiometabolic health. These programs are supported by an active research environment, where patients are able to engage in studies with a focus on improving their physical health. These studies include a longitudinal evaluation of the effects of integrated health coaching on maintaining cardiometabolic health in patients recently admitted to the program, as well as a clinical study that evaluates the effects of low versus higher metabolic risk antipsychotic drugs on central adiposity. An additional pharmacogenomic study is helping to identify genetic variants that may predict cardiometabolic changes following treatment with antipsychotic drugs.

摘要

精神障碍最常出现在青少年晚期和成年早期。一个综合医疗团队的集中和快速临床反应可以帮助改善患者的生活质量,从而带来更好的长期预后。温哥华沿海卫生局早期精神病干预计划覆盖了加拿大温哥华和里士满市约 80 万人的流域地区。该计划为最近经历首发精神病的 30 岁以下患者提供了一种多学科的方法来支持他们。该计划满足了治疗环境、药物和心理治疗的需求。这项支持的一个关键部分包括专门改善患者身体健康的计划。通过双管齐下、并行的方法来满足身体健康需求。患者在进入该计划的第一年接受常规代谢健康评估,记录标准代谢参数。根据临床访谈和实验室测试的结果,推荐具体的可操作干预措施。第二个关键策略是一个促进健康生活方式目标发展的计划。患者与职业治疗师密切合作,制定改善心脏代谢健康的目标。这些计划得到了一个积极的研究环境的支持,患者可以参与专注于改善他们身体健康的研究。这些研究包括对综合健康指导对最近入院患者心脏代谢健康的维持效果的纵向评估,以及一项评估低代谢风险与高代谢风险抗精神病药物对中心性肥胖影响的临床研究。一项额外的药物基因组学研究正在帮助确定可能预测抗精神病药物治疗后心脏代谢变化的遗传变异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8873/4155777/2622aaeb93b9/fpsyt-05-00105-g001.jpg

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