Fitzgerald P, Kulkarni J
Dandenong Hospital Department of Psychiatry, Victoria, Australia.
Br J Psychiatry Suppl. 1998;172(33):39-44.
The HOMES (Home-Oriented Management of Early Psychosis) programme is a new home-based management programme for people presenting for the first time with psychotic illnesses. The present paper aims to present preliminary data as to the efficacy of this programme and factors identified as being associated with successful prevention of hospital admission.
The programme applied to all the people presenting to the Dandenong Hospital Department of Psychiatry with first-episode psychosis who are considered suitable at first assessment for home-based management. A programme description is included in the paper. Prospective evaluation data on the first 31 people managed within the programme is presented.
Twenty-two out of 31 people were managed without the necessity for hospital admission. Illness severity was not related to the ability to manage this group of people outside of hospital. The level of social support and duration of untreated psychosis prior to treatment, may be most closely related to home-based treatment success.
Home-based management of people with first-episode psychosis is feasible and offers a viable alternative to admission for this group. Home-based treatment is dependent on the degree of social support but is independent of the degree of illness severity.
“早期精神病居家导向管理（HOMES）”项目是一项针对首次出现精神病性疾病患者的新型居家管理项目。本文旨在呈现该项目疗效的初步数据，以及确定与成功预防住院相关的因素。
该项目适用于所有首次因精神病发作到丹德农医院精神科就诊且初次评估认为适合居家管理的患者。本文包含项目描述。文中呈现了该项目管理的前31名患者的前瞻性评估数据。
31名患者中有22名无需住院即可得到管理。疾病严重程度与在院外管理这组患者的能力无关。社会支持水平和治疗前未治疗精神病的持续时间可能与居家治疗成功最为密切相关。
对首次发作精神病患者进行居家管理是可行的，为该群体提供了一种可行的替代住院的方案。居家治疗取决于社会支持程度，但与疾病严重程度无关。
