Addington Jean, Devoe Daniel J, Santesteban-Echarri Olga
Hotchkiss Brain Institute, Department of Psychiatry University of Calgary, Calgary Canada.
Mathison Centre for Mental Health Research & Education University of Calgary, Calgary Canada.
Curr Treat Options Psychiatry. 2019 Mar;6(1):1-16. doi: 10.1007/s40501-019-0164-6. Epub 2019 Jan 31.
One of the goals of identifying youth identified, based on clinical symptoms, as being at risk for developing psychosis, is to find ways to prevent or even delay the onset of the illness. Over the past 20 years, relatively few randomized control trials (RCTs), including both pharmacological and psychosocial interventions, have been conducted and often with inconsistent results. Several recent meta-analyses suggest that there are few treatments if any that might be effective and that no one treatment is seen as being more effective than any other treatment. This review aims to examine the existing RCTs and to critically review recent meta-analyses.
Individuals at clinical high risk for psychosis are a heterogenous group. Unfortunately, many interventions have not been specifically designed to address the outcome being assessed nor have participants been specifically selected for that treatment.
The trials completed to date and the recent systematic reviews should be seen positively and used to guide the design of future trials to ensure that the right interventions are offered to the right people at the right time.
基于临床症状识别出有患精神病风险的青少年,其中一个目标是找到预防甚至延缓疾病发作的方法。在过去20年里,进行的随机对照试验(RCT)相对较少,包括药物和心理社会干预,且结果往往不一致。最近的几项荟萃分析表明,几乎没有可能有效的治疗方法,也没有一种治疗方法被认为比其他治疗方法更有效。本综述旨在研究现有的随机对照试验,并对最近的荟萃分析进行批判性审视。
临床高危精神病个体是一个异质性群体。不幸的是,许多干预措施并非专门为解决所评估的结果而设计,参与者也没有专门为此种治疗而挑选。
迄今为止完成的试验和最近的系统评价应得到积极看待,并用于指导未来试验的设计,以确保在正确的时间为正确的人提供正确的干预措施。