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美国精神分裂症治疗模式的转变:RAISE 倡议。

Transforming the Treatment of Schizophrenia in the United States: The RAISE Initiative.

机构信息

New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032, USA; email:

Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.

出版信息

Annu Rev Clin Psychol. 2018 May 7;14:237-258. doi: 10.1146/annurev-clinpsy-050817-084934. Epub 2018 Jan 12.

Abstract

The schizophrenia spectrum disorders are neurodevelopmental illnesses with a lifetime prevalence near 1%, producing extensive functional impairment and low expectations for recovery. Until recently, treatment in the United States has largely attempted to stabilize individuals with chronic schizophrenia. The identification and promotion of evidence-based practices for schizophrenia via the Patient Outcomes Research Team, combined with international studies supporting the value of early intervention, provided the foundation for the Recovery After an Initial Schizophrenia Episode (RAISE) project. The RAISE studies further supported the value of reducing the duration of untreated psychosis and providing a multi-element treatment called coordinated specialty care (CSC) to improve outcomes for patients in usual treatment settings. Although CSC programs have proliferated rapidly in the United States, many challenges remain in the treatment and recovery of individuals with schizophrenia in the aftermath of RAISE.

摘要

精神分裂症谱系障碍是一种神经发育疾病,终身患病率接近 1%,会导致广泛的功能损伤和康复预期较低。直到最近,美国的治疗方法在很大程度上还停留在试图稳定慢性精神分裂症患者的阶段。通过患者结果研究团队对精神分裂症的循证实践的识别和推广,加上国际研究对早期干预价值的支持,为初始精神分裂症发作后康复(RAISE)项目奠定了基础。RAISE 研究进一步证实了缩短未治疗精神病持续时间和提供名为协调专科护理(CSC)的多元素治疗方法的价值,以改善常规治疗环境中患者的治疗结果。尽管 CSC 计划在美国迅速普及,但在 RAISE 之后,精神分裂症患者的治疗和康复仍然面临许多挑战。

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