Gouveia Marta, Morgado Tânia, Costa Tiago, Sampaio Francisco, Rosa Amorim, Sequeira Carlos
Local Health Unit of Viseu Dão-Lafões, 3504-509 Viseu, Portugal.
Abel Salazar Biomedical Sciences Institute, University of Porto, 4050-313 Porto, Portugal.
Nurs Rep. 2025 Jan 9;15(1):16. doi: 10.3390/nursrep15010016.
The aim of this scoping review was to map intervention programmes for first-episode psychosis by identifying their characteristics, participants, and specific contexts of implementation. It seems reasonable to suggest that early intervention may be beneficial in improving recovery outcomes and reducing the duration of untreated psychosis (DUP). Despite the expansion of these programmes, there are still some significant variations and barriers to access that need to be addressed. In line with the Joanna Briggs Institute (JBI) methodology and the Participants, Concept, and Context (PCC) framework, this review encompasses studies focusing on individuals grappling with early-stage psychosis and their caregivers across a range of settings, including hospital and community environments. The review identified 47 studies from 2002 to 2023, which revealed a great deal of diversity in programme characteristics and implementation contexts. This reflects a global perspective. The results showed that there is a great deal of variety in the characteristics of the programmes, with interventions ranging from single-component strategies, such as cognitive-behavioural therapy (CBT) and cognitive remediation therapy (CRT), to multicomponent programmes that integrate a number of different approaches, including psychosocial, pharmacological, and family-focused strategies. The objectives included attempts to improve cognitive functioning; enhance coping skills; reduce caregiver burden; and address symptoms such as anxiety, depression, and hallucinations. It is notable that there was considerable variation in the frequency, duration, and follow-up periods of the interventions, with some lasting just three sessions over one month and others spanning five years and 48 sessions. The majority of the programmes were delivered in community or outpatient settings, although there were also examples of hospital- and home-based interventions. These findings highlight the value of early interventions and provide a useful resource for adapting programmes to different social and cultural contexts. It would be beneficial for future research to explore how these interventions can be tailored to diverse settings.
本范围综述的目的是通过识别首次发作精神病干预项目的特征、参与者和具体实施背景来梳理这些项目。有理由认为，早期干预可能有助于改善康复结果并缩短未治疗精神病的持续时间（DUP）。尽管这些项目有所扩展，但仍存在一些重大差异和获取障碍需要解决。根据乔安娜·布里格斯研究所（JBI）的方法以及参与者、概念和背景（PCC）框架，本综述涵盖了一系列环境中关注早期精神病患者及其照顾者的研究，包括医院和社区环境。该综述从2002年至2023年共识别出47项研究，这些研究揭示了项目特征和实施背景的高度多样性。这反映了一种全球视角。结果表明，这些项目的特征有很大差异，干预措施从单一成分策略，如认知行为疗法（CBT）和认知康复疗法（CRT），到整合多种不同方法的多成分项目，包括心理社会、药物和以家庭为重点的策略。目标包括改善认知功能的尝试；增强应对技能；减轻照顾者负担；以及解决焦虑、抑郁和幻觉等症状。值得注意的是，干预的频率、持续时间和随访期存在相当大的差异，有些干预在一个月内仅持续三次，而其他干预则持续五年共48次。大多数项目是在社区或门诊环境中实施的，不过也有基于医院和家庭的干预例子。这些发现凸显了早期干预的价值，并为使项目适应不同社会和文化背景提供了有用资源。未来研究探索如何针对不同环境调整这些干预措施将是有益的。
