Wing Chung Chang, MRCPsych, FHKCPsych, Gloria Hoi Kei Chan, MPhil, Olivia Tsz Ting Jim, BsocSc, Department of Psychiatry, University of Hong Kong; Emily Sin Kei Lau, BsocSc, Department of Psychiatry, Queen Mary Hospital, Hong Kong; Christy Lai Ming Hui, PhD, Sherry Kit Wa Chan, MRCPsych, Edwin Ho Ming Lee, MRCPsych, FHKCPsych, Department of Psychiatry, University of Hong Kong; Eric Yu Hai Chen, MD, Department of Psychiatry, University of Hong Kong and State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong.
Br J Psychiatry. 2015 Jun;206(6):492-500. doi: 10.1192/bjp.bp.114.150144. Epub 2015 Feb 5.
Numerous early intervention services targeting young people with psychosis have been established, based on the premise that reducing treatment delay and providing intensive treatment in the initial phase of psychosis can improve long-term outcome.
To establish the effect of extending a specialised early intervention treatment for first-episode psychosis by 1 year.
A randomised, single-blind controlled trial (NCT01202357) compared a 1-year extension of specialised early intervention with step-down care in patients who had all received a 2-year intensive early intervention programme for first-episode psychosis.
Patients receiving an additional year of specialised intervention had better outcomes in functioning, negative and depressive symptoms and treatment default rate than those managed by step-down psychiatric care.
Extending the period of specialised early intervention is clinically desirable but may not be feasible in lower-income countries.
基于减少治疗延迟和在精神病发病初期提供强化治疗可以改善长期预后的前提，已经建立了许多针对年轻精神病患者的早期干预服务。
确定将针对首发精神病的专门早期干预治疗延长 1 年的效果。
一项随机、单盲对照试验（NCT01202357）比较了在所有接受了 2 年强化首发精神病早期干预的患者中，延长 1 年专门早期干预与逐步降级护理的效果。
与接受逐步降级精神科护理的患者相比，接受额外 1 年专门干预的患者在功能、阴性和抑郁症状以及治疗中断率方面的结果更好。
延长专门早期干预的时间在临床上是可取的，但在低收入国家可能不可行。
