1 Department of Psychiatry, Hotchkiss Brain Institute, Foothills Medical Centre, University of Calgary, Calgary, Alberta.
2 Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia.
Can J Psychiatry. 2017 Sep;62(9):594-603. doi: 10.1177/0706743717719899. Epub 2017 Jul 21.
The objective of this article is to identify best practices in the diagnosis and assessment of patients with schizophrenia spectrum and other psychotic disorders. The diagnosis and assessment may occur in a range of situations from the emergency room to the outpatient clinic and at different stages of the disorder. The focus may be on acute exacerbations of illness, residual symptoms, levels of function, or changes in the response to treatment.
A systematic search was conducted for guidelines published in the last 5 years for schizophrenia and schizophrenia spectrum disorders. The guidelines were rated by at least 2 raters, and recommendations adopted on the diagnosis and assessment were primarily drawn from the American Psychiatric Association practice guidelines for the psychiatric evaluation of adults and the National Institute for Health and Care Excellence guideline on psychosis and schizophrenia in adults. A number of de novo recommendations were also developed.
Eleven recommendations were identified that cover a range of assessment situations from diagnosis to the involvement of families in assessments.
An accurate assessment establishes the baseline for treatment planning based on clinical decision making for both pharmacotherapy and psychosocial treatments.
本文旨在确定精神分裂症谱系及其他精神病性障碍患者的诊断和评估的最佳实践。诊断和评估可能发生在从急诊室到门诊的各种情况下,以及疾病的不同阶段。重点可能是疾病急性加重、残留症状、功能水平,或对治疗反应的变化。
对过去 5 年发表的精神分裂症和精神分裂症谱系障碍的指南进行了系统搜索。至少有 2 名评估者对指南进行了评分,关于诊断和评估的建议主要来自美国精神病学协会成人精神评估实践指南和英国国家卫生与保健优化研究所成人精神病和精神分裂症指南。还制定了一些新的建议。
确定了 11 项建议,涵盖了从诊断到家庭参与评估等一系列评估情况。
准确的评估为基于临床决策的药物治疗和心理社会治疗的治疗计划建立了基线。