Orygen, Australia; and Center for Youth Mental Health, The University of Melbourne, Australia.
Australas Psychiatry. 2020 Jun;28(3):331-334. doi: 10.1177/1039856220924323. Epub 2020 May 21.
Face validity and the best available evidence strongly support the value of early intervention (EI) for psychotic disorders, and increasingly for other mental illnesses. Yet its value continues to be intensely criticised by some academics and doubted by many psychiatrists. This disconnect is examined through the lens of the 'clinician's illusion'.
A number of sources fuel resistance to EI; however, the cumulative exposure to persistent and disabling illness that dominates the day-to-day experience of psychiatrists may be a key influence. This experience forms the basis of the clinician's illusion, a hidden bias health professionals develop as a natural consequence of their clinical experiences, which shapes belief and perception of prognosis, and breeds therapeutic nihilism. This bias has been reinforced by grossly under-resourced systems of mental health care, undermining morale and adding a sense of learned helplessness to our mindset.
表面效度和现有最佳证据有力地支持了早期干预（EI）在精神病性障碍中的价值，并且越来越多地支持其他精神疾病。然而，它的价值仍然受到一些学者的强烈批评，许多精神病学家也对此表示怀疑。这种脱节通过“临床医生的错觉”这一视角来审视。
有许多因素助长了对 EI 的抵制；然而，精神科医生日常工作中接触到的持续且使人丧失能力的疾病，可能是一个关键的影响因素。这种经历构成了临床医生错觉的基础，这是健康专业人员由于其临床经验而自然产生的一种隐性偏见，这种偏见会影响对预后的信念和感知，并滋生治疗虚无主义。这种偏见受到精神卫生保健系统资源严重不足的强化，这削弱了士气，并使我们的思维方式产生了一种习得性无助感。
