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青少年心理健康的预防与早期干预:是否是时候采用多学科和跨诊断的护理模式了?

Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care?

作者信息

Colizzi Marco, Lasalvia Antonio, Ruggeri Mirella

机构信息

1Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.

2Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF UK.

出版信息

Int J Ment Health Syst. 2020 Mar 24;14:23. doi: 10.1186/s13033-020-00356-9. eCollection 2020.

Abstract

BACKGROUND

Similar to other health care sectors, mental health has moved towards the secondary prevention, with the effort to detect and treat mental disorders as early as possible. However, converging evidence sheds new light on the potential of primary preventive and promotion strategies for mental health of young people. We aimed to reappraise such evidence.

METHODS

We reviewed the current state of knowledge on delivering promotion and preventive interventions addressing youth mental health.

RESULTS

Half of all mental disorders start by 14 years and are usually preceded by non-specific psychosocial disturbances potentially evolving in any major mental disorder and accounting for 45% of the global burden of disease across the 0-25 age span. While some action has been taken to promote the implementation of services dedicated to young people, mental health needs during this critical period are still largely unmet. This urges redesigning preventive strategies in a youth-focused multidisciplinary and trans-diagnostic framework which might early modify possible psychopathological trajectories.

CONCLUSIONS

Evidence suggests that it would be unrealistic to consider promotion and prevention in mental health responsibility of mental health professionals alone. Integrated and multidisciplinary services are needed to increase the range of possible interventions and limit the risk of poor long-term outcome, with also potential benefits in terms of healthcare system costs. However, mental health professionals have the scientific, ethical, and moral responsibility to indicate the direction to all social, political, and other health care bodies involved in the process of meeting mental health needs during youth years.

摘要

背景

与其他医疗保健领域类似,心理健康已朝着二级预防发展,致力于尽早发现和治疗精神障碍。然而,越来越多的证据为青少年心理健康的一级预防和促进策略的潜力带来了新的启示。我们旨在重新评估此类证据。

方法

我们回顾了关于提供促进和预防青少年心理健康干预措施的现有知识状况。

结果

所有精神障碍中有一半在14岁之前开始,通常之前会出现非特异性心理社会干扰,这些干扰可能演变成任何主要精神障碍,并占0至25岁年龄段全球疾病负担的45%。虽然已经采取了一些行动来促进专门针对年轻人的服务的实施,但这一关键时期的心理健康需求仍在很大程度上未得到满足。这促使在以青少年为重点的多学科和跨诊断框架中重新设计预防策略,这可能会早期改变可能的精神病理轨迹。

结论

有证据表明,仅将心理健康促进和预防视为心理健康专业人员的责任是不现实的。需要综合的多学科服务来增加可能的干预措施范围,并限制长期不良后果的风险,同时在医疗保健系统成本方面也可能带来好处。然而,心理健康专业人员有科学、伦理和道德责任为所有参与满足青少年心理健康需求过程的社会、政治和其他医疗保健机构指明方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9169/7092613/386cbd3ef689/13033_2020_356_Fig1_HTML.jpg

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