Linszen D H, Dingemans P M, Lenior M E, Scholte W F, de Haan L, Goldstein M J
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, The Netherlands.
Int Clin Psychopharmacol. 1998 Mar;13 Suppl 3:S31-4. doi: 10.1097/00004850-199803003-00006.
During the course of schizophrenia, symptoms tend to increase at the highest rate during the first 5 years of the disease. Moreover, 10% of suicides by schizophrenic patients occur within the first 10 years of schizophrenia being diagnosed. These facts emphasize the importance of early intervention to improve the course of the disease before further deterioration. The use of psychosocial interventions and drug management programmes, in addition to maintenance antipsychotic medication, reduces the risk of psychotic relapse. Continuity of care from inpatient to outpatient treatment also significantly improves outcome, largely as a result of better drug compliance. It appears, however, that the addition of a behavioural family intervention alone to a standard programme offers little additional benefit. The benefits of intervention programmes last only as long as the programme, and patients should continue with such intensive treatment strategies for at least the duration of the critical phase. Under these circumstances, very mild psychotic complaints may be recognized at an early stage so that treatment can begin even earlier, further increasing the chance of an optimal long-term outcome. Further studies of early intervention and relapse prevention are required to support these findings.
在精神分裂症病程中，症状往往在疾病的头5年以最快的速度增加。此外，精神分裂症患者自杀的10%发生在精神分裂症被诊断后的头10年内。这些事实强调了早期干预以在疾病进一步恶化之前改善病程的重要性。除维持性抗精神病药物治疗外，使用心理社会干预和药物管理方案可降低精神病复发的风险。从住院治疗到门诊治疗的持续护理也显著改善了治疗效果，这主要是因为更好的药物依从性。然而，似乎仅在标准方案中增加行为家庭干预几乎没有额外的益处。干预方案的益处仅在方案实施期间持续，患者应至少在关键阶段持续采用这种强化治疗策略。在这种情况下，非常轻微的精神病性主诉可能在早期被识别出来，以便更早开始治疗，进一步增加获得最佳长期治疗效果的机会。需要进一步研究早期干预和预防复发以支持这些发现。
