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改善瑞士高精神病风险患者的就医途径:PsyYoung研究方案

Improving Pathways to Care for Patients at High Psychosis Risk in Switzerland: PsyYoung Study Protocol.

作者信息

Conchon Caroline, Sprüngli-Toffel Elodie, Alameda Luis, Edan Anne, Bailey Barbara, Solida Alessandra, Plessen Kerstin Jessica, Conus Philippe, Kapsaridi Afroditi, Genoud Davina, Crameri Aureliano, Jouabli Sondes, Caron Camille, Grob Carmina, Gros Julia, Senn Smeralda, Curtis Logos, Liso Navarro Ana, Barbe Remy, Nanzer Nathalie, Herbrecht Evelyn, Huber Christian G, Micali Nadia, Armando Marco, Borgwardt Stefan, Andreou Christina

机构信息

General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, 1003 Lausanne, Switzerland.

Psychology and Neuroscience, King's College of London, London SE5 8AF, UK.

出版信息

J Clin Med. 2023 Jul 12;12(14):4642. doi: 10.3390/jcm12144642.

Abstract

AIMS

Psychotic disorders are one of the main causes of chronic disability in young people. An at-risk mental state (ARMS) is represented by subclinical symptoms that precede the first episode of psychosis (FEP). The PsyYoung project aims to optimize the detection of an ARMS while reducing unnecessary psychiatric treatments. It investigates the effects of service changes on the referrals and outcomes of young people with ARMS or a FEP.

METHODS

Six psychiatric outpatient clinics in three cantons (Basel-Stadt, Vaud, and Geneva) participated in the project. They passed through an implementation phase including service changes and the adaptation of a standardized stepped care model for diagnosis and assessment, in addition to measures for increasing the awareness, networking and training of local professionals.

PRELIMINARY RESULTS

All participating cantons had entered the implementation phase. By March 2023, there were 619 referrals to participating sites. A total of 163 patients (37% FEP and 31% ARMS) and 15 close relatives had participated in individual longitudinal assessments, and 26 patients participated in qualitative interviews.

CONCLUSION

This national collaborative project addresses the issue of early intervention for emerging psychoses, and creates spaces for fruitful reflections and collaboration in Switzerland. The ultimate aim of PsyYoung is to harmonize clinical practices in early intervention of psychosis on a national level.

摘要

目的

精神障碍是年轻人慢性残疾的主要原因之一。处于精神病发作风险的精神状态(ARMS)以精神病首次发作(FEP)之前的亚临床症状为特征。PsyYoung项目旨在优化对ARMS的检测,同时减少不必要的精神科治疗。该项目调查服务变革对患有ARMS或FEP的年轻人的转诊情况及治疗结果的影响。

方法

三个州(巴塞尔市、沃州和日内瓦)的六家精神科门诊诊所参与了该项目。除了提高当地专业人员的意识、加强网络联系和培训的措施外,它们还经历了一个实施阶段,包括服务变革以及采用标准化的分级护理模式进行诊断和评估。

初步结果

所有参与的州均已进入实施阶段。截至2023年3月,共有619例转诊至参与项目的机构。共有163名患者(37%为FEP,31%为ARMS)和15名近亲参与了个体纵向评估,26名患者参与了定性访谈。

结论

这个全国性合作项目解决了新发精神病的早期干预问题,并在瑞士创造了进行富有成效的思考和合作的空间。PsyYoung的最终目标是在国家层面协调精神病早期干预的临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f079/10380609/f585a5434eee/jcm-12-04642-g004.jpg

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