Thompson Elizabeth, Millman Zachary B, Okuzawa Nana, Mittal Vijay, DeVylder Jordan, Skadberg Travis, Buchanan Robert W, Reeves Gloria M, Schiffman Jason
*Department of Psychology, University of Maryland, Baltimore County; †Division of Child and Adolescent Psychiatry, University of Maryland, Baltimore; ‡Department of Psychology and Neuroscience, University of Colorado at Boulder; and §School of Social Work and ∥Maryland Psychiatric Research Center, School of Medicine, University of Maryland, Baltimore.
J Nerv Ment Dis. 2015 May;203(5):342-51. doi: 10.1097/NMD.0000000000000287.
Youth and young adults at clinical high risk (CHR) for psychosis experience a broad range of difficulties, including attenuated psychotic symptoms, comorbid concerns, functional impairments, and family and interpersonal stress. Given emerging evidence that early interventions may improve functioning and reduce symptomatology while also lowering risk of transition to full-threshold psychosis, several randomized controlled trials have systematically evaluated the efficacy of CHR treatment approaches. This article describes and summarizes psychosocial intervention approaches that have demonstrated efficacy in treating people at CHR, with a focus on distilling individual components of these treatments. On the basis of the existing literature, we propose an empirically based, flexible, and comprehensive modularized approach to early intervention that meets the varying needs of individuals experiencing CHR-related distress and dysfunction, many of whom may be on a trajectory toward psychosis.
处于临床高危（CHR）状态的青少年和青年会经历各种各样的困难，包括精神病性症状减弱、共病问题、功能损害以及家庭和人际压力。鉴于新出现的证据表明早期干预可能改善功能、减轻症状，同时降低发展为完全阈值精神病的风险，几项随机对照试验系统地评估了CHR治疗方法的疗效。本文描述并总结了已证明对CHR人群有效的心理社会干预方法，重点提炼这些治疗的各个组成部分。基于现有文献，我们提出一种基于实证、灵活且全面的模块化早期干预方法，以满足经历与CHR相关困扰和功能障碍的个体的不同需求，其中许多人可能正处于发展为精神病的轨迹上。
