Department of Psychiatry, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany.
Laboratory of Molecular Psychiatry and Unit of Treatment Resistant Psychosis, University School of Medicine of Naples Federico II, Napoli, Italy.
Neuropsychiatr Dis Treat. 2014 Sep 24;10:1867-78. doi: 10.2147/NDT.S61672. eCollection 2014.
Prompt administration of antipsychotic treatment that is adhered to is essential for the optimal treatment of schizophrenia. Many patients have benefited from the advent of second-generation antipsychotics, which can offer good symptomatic control with reduced incidence of extrapyramidal symptoms, although with higher risk of metabolic side effects. It is unsurprising that accounts as to whether first- and second-generation antipsychotics differ in their efficacy vary, since treatment effectiveness is a broad notion and difficult to define.
Numerous factors may be used to gauge treatment effectiveness and, while it has largely been defined in terms of improvements in four domains (symptoms of disease, treatment burden, disease burden, and health and wellness), the real-world clinical utility of this consensus is unclear. Therefore, this article aims to provide a framework that can aid psychiatrists in making assessments about treatment effectiveness.
A panel of 12 psychiatrists and psychopharmacologists convened to develop and propose an accessible and globally-applicable framework for assessing the effectiveness of antipsychotic treatments in patients with schizophrenia. Following presentation of a preliminary proposal to a wider group of psychiatrists from across Europe, it was refined into a framework comprising five domains: symptomatic remission and retention of treatment; affective symptoms; cognitive functioning; treatment satisfaction; and personal and social functioning - each of which is discussed in this article.
This article provides a framework that can aid psychiatrists in making assessments about treatment effectiveness. It is anticipated that the framework outlined here may contribute to improving clinical practice through the promotion of a patient-centered approach to the assessment of treatment effectiveness, using five specified domains, in patients with schizophrenia.
及时遵循抗精神病药物治疗是精神分裂症最佳治疗的关键。第二代抗精神病药物的出现使许多患者受益，它们可以提供良好的症状控制，减少锥体外系症状的发生，但代谢副作用的风险较高。第一代和第二代抗精神病药在疗效上是否存在差异，这一点并不奇怪，因为治疗效果是一个广泛的概念，难以定义。
有许多因素可用于衡量治疗效果，虽然它主要是根据四个领域（疾病症状、治疗负担、疾病负担和健康与幸福）的改善来定义的，但这一共识在现实临床中的实际应用尚不清楚。因此，本文旨在提供一个框架，帮助精神科医生评估治疗效果。
一个由 12 名精神科医生和精神药理学家组成的小组召开会议，制定并提出了一个用于评估精神分裂症患者抗精神病治疗效果的易于理解且适用于全球的框架。在向来自欧洲各地的更多精神科医生展示了初步提案后，该框架被进一步细化为五个领域：症状缓解和治疗保留；情感症状；认知功能；治疗满意度；个人和社会功能-本文将对每一个领域进行讨论。
本文提供了一个框架，可以帮助精神科医生评估治疗效果。预计这里概述的框架可以通过促进以患者为中心的方法来评估治疗效果，使用五个指定的领域，从而改善精神分裂症患者的临床实践。
