• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

分期治疗早期精神病：精神病超高危患者干预的序贯多项分配随机试验。

Staged Treatment in Early Psychosis: A sequential multiple assignment randomised trial of interventions for ultra high risk of psychosis patients.

机构信息

Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

出版信息

Early Interv Psychiatry. 2018 Jun;12(3):292-306. doi: 10.1111/eip.12459. Epub 2017 Jul 18.

DOI:10.1111/eip.12459
PMID:28719151
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6054879/
Abstract

AIM

Previous research indicates that preventive intervention is likely to benefit patients "at risk" of psychosis, in terms of functional improvement, symptom reduction and delay or prevention of onset of threshold psychotic disorder. The primary aim of the current study is to test outcomes of ultra high risk (UHR) patients, primarily functional outcome, in response to a sequential intervention strategy consisting of support and problem solving (SPS), cognitive-behavioural case management and antidepressant medication. A secondary aim is to test biological and psychological variables that moderate and mediate response to this sequential treatment strategy.

METHODS

This is a sequential multiple assignment randomised trial (SMART) consisting of three steps: Step 1: SPS (1.5 months); Step 2: SPS vs Cognitive Behavioural Case Management (4.5 months); Step 3: Cognitive Behavioural Case Management + Antidepressant Medication vs Cognitive Behavioural Case Management + Placebo (6 months). The intervention is of 12 months duration in total and participants will be followed up at 18 months and 24 months post baseline.

CONCLUSION

This paper reports on the rationale and protocol of the Staged Treatment in Early Psychosis (STEP) study. With a large sample of 500 UHR participants this study will investigate the most effective type and sequence of treatments for improving functioning and reducing the risk of developing psychotic disorder in this clinical population.

摘要

目的

先前的研究表明，预防干预可能有益于处于精神病前期的“高危”患者，这体现在功能改善、症状减轻、以及发病阈值性精神病障碍的延迟或预防上。本研究的主要目的是检验超高危（UHR）患者的预后，主要是功能预后，他们接受的是包括支持和问题解决（SPS）、认知行为管理和抗抑郁药物在内的序贯干预策略。次要目的是检验生物和心理变量对这种序贯治疗策略的调节和中介作用。

方法

这是一项由三个步骤组成的序贯多重分配随机试验（SMART）：步骤 1：SPS（1.5 个月）；步骤 2：SPS 与认知行为管理（4.5 个月）；步骤 3：认知行为管理+抗抑郁药与认知行为管理+安慰剂（6 个月）。干预总共持续 12 个月，参与者将在基线后 18 个月和 24 个月进行随访。

结论

本文报告了早期精神病分期治疗（STEP）研究的基本原理和方案。该研究纳入了 500 名 UHR 参与者的大样本，将调查改善功能和降低该临床人群出现精神病障碍风险的最有效治疗类型和顺序。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da13/6054879/c4ead255c1b8/nihms981054f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da13/6054879/c4ead255c1b8/nihms981054f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da13/6054879/c4ead255c1b8/nihms981054f1.jpg

相似文献

1
Staged Treatment in Early Psychosis: A sequential multiple assignment randomised trial of interventions for ultra high risk of psychosis patients.分期治疗早期精神病：精神病超高危患者干预的序贯多项分配随机试验。
Early Interv Psychiatry. 2018 Jun;12(3):292-306. doi: 10.1111/eip.12459. Epub 2017 Jul 18.
2
A Sequential Adaptive Intervention Strategy Targeting Remission and Functional Recovery in Young People at Ultrahigh Risk of Psychosis: The Staged Treatment in Early Psychosis (STEP) Sequential Multiple Assignment Randomized Trial.针对精神病超高风险青年人群的缓解和功能恢复的序贯适应性干预策略：早期精神病的分期治疗（STEP）序贯多项分配随机试验。
JAMA Psychiatry. 2023 Sep 1;80(9):875-885. doi: 10.1001/jamapsychiatry.2023.1947.
3
Baseline data of a sequential multiple assignment randomized trial (STEP study).序贯多项分配随机试验（STEP 研究）的基线数据。
Early Interv Psychiatry. 2022 Oct;16(10):1130-1142. doi: 10.1111/eip.13263. Epub 2022 Jan 30.
4
Staged treatment and acceptability guidelines in early psychosis study (STAGES): A randomized placebo controlled trial of intensive psychosocial treatment plus or minus antipsychotic medication for first-episode psychosis with low-risk of self-harm or aggression. Study protocol and baseline characteristics of participants.分期治疗和早期精神病研究中的可接受性指南 (STAGES)：一项针对首发精神病且自我伤害或攻击风险低的患者的随机安慰剂对照试验，比较强化心理社会治疗加或不加抗精神病药物治疗的效果。研究方案和参与者的基线特征。
Early Interv Psychiatry. 2019 Aug;13(4):953-960. doi: 10.1111/eip.12716. Epub 2018 Jul 19.
5
Efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL) in early psychosis: study protocol for a multi-centre randomized controlled trial.日常生活中的接纳与承诺疗法（ACT-DL）在早期精神病中的疗效：一项多中心随机对照试验的研究方案。
Trials. 2019 Dec 26;20(1):769. doi: 10.1186/s13063-019-3912-4.
6
Multimodal prevention of first psychotic episode through N-acetyl-l-cysteine and integrated preventive psychological intervention in individuals clinically at high risk for psychosis: Protocol of a randomized, placebo-controlled, parallel-group trial.多模态预防首发精神病：N-乙酰半胱氨酸与综合预防心理干预对精神病高危个体的效果：一项随机、安慰剂对照、平行分组试验方案。
Early Interv Psychiatry. 2019 Dec;13(6):1404-1415. doi: 10.1111/eip.12781. Epub 2019 Feb 19.
7
Is clinical intervention in the ultra high risk phase effective?超早期阶段的临床干预是否有效？
Braz J Psychiatry. 2011 Oct;33 Suppl 2:s161-74. doi: 10.1590/s1516-44462011000600004.
8
Antipsychotic medication versus psychological intervention versus a combination of both in adolescents with first-episode psychosis (MAPS): a multicentre, three-arm, randomised controlled pilot and feasibility study.抗精神病药物与心理干预及两者联合用于首发精神病青少年（MAPS）：一项多中心、三臂、随机对照试验性及可行性研究
Lancet Psychiatry. 2020 Sep;7(9):788-800. doi: 10.1016/S2215-0366(20)30248-0. Epub 2020 Jul 7.
9
Early psychotic experiences: Interventions, problems and perspectives.早期精神病性体验：干预措施、问题与展望。
Psychiatriki. 2015 Jan-Mar;26(1):45-54.
10
NEURAPRO-E study protocol: a multicentre randomized controlled trial of omega-3 fatty acids and cognitive-behavioural case management for patients at ultra high risk of schizophrenia and other psychotic disorders.NEURAPRO-E研究方案：一项针对精神分裂症及其他精神障碍超高风险患者的ω-3脂肪酸与认知行为病例管理的多中心随机对照试验。
Early Interv Psychiatry. 2017 Oct;11(5):418-428. doi: 10.1111/eip.12260. Epub 2015 Aug 16.

引用本文的文献

1
Transdiagnostic Symptom Dimensions in Individuals at Ultra-High Risk for Psychosis: Towards Dimensional Representations of Pluripotent Risk.超高危精神病个体的跨诊断症状维度：迈向多能风险的维度表征
Early Interv Psychiatry. 2025 Aug;19(8):e70086. doi: 10.1111/eip.70086.
2
White Blood Cell Proportions Are Associated With Response to Psychosocial Therapy in Young People at Ultra-High Risk for Psychosis.白细胞比例与超高风险精神病青少年心理社会治疗反应相关。
Biol Psychiatry Glob Open Sci. 2025 Jun 3;5(5):100546. doi: 10.1016/j.bpsgos.2025.100546. eCollection 2025 Sep.
3
Design characteristics of Sequential Multiple Assignment Randomized Trials (SMARTs) for human health: a scoping review of studies between 2009-2024.

本文引用的文献

1
Effect of ω-3 Polyunsaturated Fatty Acids in Young People at Ultrahigh Risk for Psychotic Disorders: The NEURAPRO Randomized Clinical Trial.ω-3 多不饱和脂肪酸对超高精神病风险青年的影响：NEURAPRO 随机临床试验。
JAMA Psychiatry. 2017 Jan 1;74(1):19-27. doi: 10.1001/jamapsychiatry.2016.2902.
2
Adaptive Designs for Clinical Trials.临床试验的适应性设计
N Engl J Med. 2016 Jul 7;375(1):65-74. doi: 10.1056/NEJMra1510061.
3
Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention.
人类健康序贯多重分配随机试验（SMARTs）的设计特征：2009年至2024年研究的范围综述
medRxiv. 2025 Jun 8:2025.06.06.25329149. doi: 10.1101/2025.06.06.25329149.
4
What Do We Risk to SQuEASE by Making Psychiatric Phenomenology Too Efficient?将精神现象学变得过于高效会让我们在SQuEASE中面临什么风险？
Psychopathology. 2025 Mar 28:1-4. doi: 10.1159/000545169.
5
Development and temporal validation of a clinical prediction model of transition to psychosis in individuals at ultra-high risk in the UHR 1000+ cohort.UHR 1000+队列中超高风险个体向精神病转变的临床预测模型的开发与时间验证。
World Psychiatry. 2024 Oct;23(3):400-410. doi: 10.1002/wps.21240.
6
Distress Related to Attenuated Psychotic Symptoms: Static and Dynamic Association With Transition to Psychosis, Nonremission, and Transdiagnostic Symptomatology in Clinical High-Risk Patients in an International Intervention Trial.与精神病性症状减弱相关的痛苦：国际干预试验中临床高危患者向精神病转变、未缓解及跨诊断症状学的静态和动态关联
Schizophr Bull Open. 2020 Mar 2;3(1):sgaa006. doi: 10.1093/schizbullopen/sgaa006. eCollection 2022 Jan.
7
Web-based interpretation bias training to reduce anxiety: A sequential, multiple-assignment randomized trial.基于网络的解释偏差训练以减轻焦虑：一项序贯多分配随机试验。
J Consult Clin Psychol. 2024 Jun;92(6):367-384. doi: 10.1037/ccp0000896.
8
The influence of complex psychiatric comorbidities on treatment for clinical high-risk for psychosis: A preliminary study.复杂精神共病对精神病临床高危治疗的影响：一项初步研究。
Early Interv Psychiatry. 2024 Oct;18(10):888-893. doi: 10.1111/eip.13590. Epub 2024 Jul 10.
9
A Sequential Adaptive Intervention Strategy Targeting Remission and Functional Recovery in Young People at Ultrahigh Risk of Psychosis: The Staged Treatment in Early Psychosis (STEP) Sequential Multiple Assignment Randomized Trial.针对精神病超高风险青年人群的缓解和功能恢复的序贯适应性干预策略：早期精神病的分期治疗（STEP）序贯多项分配随机试验。
JAMA Psychiatry. 2023 Sep 1;80(9):875-885. doi: 10.1001/jamapsychiatry.2023.1947.
10
A network analysis of anxiety, depressive, and psychotic symptoms and functioning in children and adolescents at clinical high risk for psychosis.对处于精神病临床高危状态的儿童和青少年的焦虑、抑郁及精神病性症状与功能的网络分析。
Front Psychiatry. 2022 Oct 28;13:1016154. doi: 10.3389/fpsyt.2022.1016154. eCollection 2022.
对超高精神疾病风险样本中降低转换率的进一步研究：早期干预的可能作用。
Schizophr Res. 2016 Jul;174(1-3):43-49. doi: 10.1016/j.schres.2016.04.040. Epub 2016 May 9.
4
Four-Year Follow-up of Cognitive Behavioral Therapy in Persons at Ultra-High Risk for Developing Psychosis: The Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial.对超高精神病发病风险人群进行认知行为疗法的四年随访：荷兰早期检测干预评估（EDIE-NL）试验
Schizophr Bull. 2016 Sep;42(5):1243-52. doi: 10.1093/schbul/sbw018. Epub 2016 Mar 18.
5
Schizophrenia risk from complex variation of complement component 4.补体成分4的复杂变异导致精神分裂症的风险。
Nature. 2016 Feb 11;530(7589):177-83. doi: 10.1038/nature16549. Epub 2016 Jan 27.
6
Declining transition rates to psychotic disorder in "ultra-high risk" clients: Investigation of a dilution effect.“超高风险”人群中精神病性障碍转化率的下降：稀释效应调查。
Schizophr Res. 2016 Jan;170(1):130-6. doi: 10.1016/j.schres.2015.11.026. Epub 2015 Dec 7.
7
Antidepressant, antipsychotic and psychological interventions in subjects at high clinical risk for psychosis: OASIS 6-year naturalistic study.对处于精神病高临床风险的受试者进行抗抑郁药、抗精神病药及心理干预：OASIS 6年自然主义研究。
Psychol Med. 2015 Apr;45(6):1327-39. doi: 10.1017/S003329171400244X. Epub 2014 Oct 22.
8
Demographic and clinical characteristics of young people seeking help at youth mental health services: baseline findings of the Transitions Study.在青少年心理健康服务机构寻求帮助的年轻人的人口统计学和临床特征：转型研究的基线结果。
Early Interv Psychiatry. 2015 Dec;9(6):487-97. doi: 10.1111/eip.12133. Epub 2014 Mar 28.
9
Declining transition rates to psychosis: the contribution of potential changes in referral pathways to an ultra-high-risk service.精神病转化率下降：转诊途径潜在变化对超高风险服务的影响
Early Interv Psychiatry. 2015 Jun;9(3):200-6. doi: 10.1111/eip.12105. Epub 2013 Nov 14.
10
Impaired context processing as a potential marker of psychosis risk state.语境处理受损可作为精神病风险状态的潜在标志物。
Psychiatry Res. 2014 Jan 30;221(1):13-20. doi: 10.1016/j.pscychresns.2013.09.001. Epub 2013 Oct 11.