Fusar-Poli Paolo, Salazar de Pablo Gonzalo, Rajkumar Ravi Philip, López-Díaz Álvaro, Malhotra Savita, Heckers Stephan, Lawrie Stephen M, Pillmann Frank
Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERSAM, Madrid, Spain.
Lancet Psychiatry. 2022 Jan;9(1):72-83. doi: 10.1016/S2215-0366(21)00121-8. Epub 2021 Nov 29.
Brief psychotic episodes represent an intriguing paradox in clinical psychiatry because they elude the standard knowledge that applies to the persisting psychotic disorders such as schizophrenia. This Review describes key diagnostic considerations such as conceptual foundations, current psychiatric classification versus research-based operationalisations, epidemiology, and sociocultural variations; prognostic aspects including the risk of psychosis recurrence, types of psychotic recurrences, other clinical outcomes, prognostic factors; and therapeutic issues such as treatment guidelines and unmet need of care. The advances and challenges associated with the scientific evidence are used to set a research agenda in this area. We conclude that brief psychotic episodes can be reconceptualised within a clinical staging model to promote innovative translational research and improve our understanding and treatment of psychotic disorders.
短暂性精神病性发作在临床精神病学中是一个有趣的悖论，因为它们不符合适用于持续性精神病性障碍（如精神分裂症）的标准认知。本综述描述了关键的诊断考量因素，如概念基础、当前的精神病学分类与基于研究的操作性定义、流行病学以及社会文化差异；预后方面，包括精神病复发风险、精神病复发类型、其他临床结局、预后因素；以及治疗问题，如治疗指南和未满足的护理需求。与科学证据相关的进展和挑战被用于设定该领域的研究议程。我们得出结论，短暂性精神病性发作可以在临床分期模型中重新概念化，以促进创新性的转化研究，并增进我们对精神病性障碍的理解和治疗。
