Schooler N R, Keith S J, Severe J B, Matthews S M
Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.
Psychiatr Q. 1995 Winter;66(4):279-92. doi: 10.1007/BF02238750.
Maintenance treatment in schizophrenia requires the integration of both medication and psychosocial treatment interventions for maximum effect. We review the recent evidence for strategies drawn from both domains. For the use of anti-psychotic medication we focus on studies of dose reduction using two strategies that differ in assumptions regarding the action of medication. They are: continuous low-dose and targeted, early intervention or intermittent treatment. For psychosocial interventions we focus on studies of family treatment. Regarding dose reduction, we conclude that both strategies are feasible but the targeted strategy incurs higher relapse and rehospitalization rates. Regarding family treatment, we conclude that family treatment provides benefits beyond other psychosocial interventions or usual care, but that there is no evidence for differences in efficacy among family treatments.
精神分裂症的维持治疗需要整合药物治疗和心理社会治疗干预措施，以达到最大效果。我们回顾了这两个领域近期的策略证据。对于抗精神病药物的使用，我们重点关注使用两种在药物作用假设上不同的策略进行剂量减少的研究。它们是：持续低剂量以及有针对性的早期干预或间歇性治疗。对于心理社会干预，我们重点关注家庭治疗的研究。关于剂量减少，我们得出结论，两种策略都是可行的，但有针对性的策略会导致更高的复发率和再住院率。关于家庭治疗，我们得出结论，家庭治疗比其他心理社会干预或常规护理更有益，但没有证据表明不同家庭治疗在疗效上存在差异。
