Power P, Elkins K, Adlard S, Curry C, McGorry P, Harrigan S
Early Psychosis Prevention and Intervention Centre, Parkville, Victoria, Australia.
Br J Psychiatry Suppl. 1998;172(33):71-6.
The Early Psychosis Prevention and Intervention Centre (EPPIC) commenced operation in Melbourne, Australia, in 1992. It offers a model for management of first-episode psychosis, utilising principles of early detection, low-dose medication and comprehensive psychosocial interventions within the least restrictive setting.
Data were examined from the first three months of treatment for all consecutive people with first-episode psychosis (n = 231) accepted in the programme in 1995-1996. A subsample of patients (n = 120) was assessed comparing clinical ratings with variables of gender, diagnosis, hospitalisation, and medication.
Hospitalisations were brief, and avoided for a third of the people. Low-dose antipsychotic medication was maintained in both in-patient and community settings. Those people with manic psychosis were more likely to be hospitalised. Hospitalised people received higher antipsychotic dosages, and had a greater rate of reduction in Brief Psychiatric Rating Scale psychotic subscale scores at three months follow-up. Eighty per cent of a representative subsample had responded to treatment and 63% were in remission by the end of the three months.
This naturalistic study suggests that the feasibility of implementing the EPPIC model in a range of clinical settings is promising and applicable in practice.
早期精神病预防与干预中心（EPPIC）于1992年在澳大利亚墨尔本开始运营。它提供了一种首发精神病管理模式，在限制最少的环境中运用早期发现、低剂量药物治疗和综合社会心理干预原则。
对1995 - 1996年该项目收治的所有连续首发精神病患者（n = 231）治疗的前三个月数据进行检查。对一个患者子样本（n = 120）进行评估，比较临床评分与性别、诊断、住院情况和药物治疗等变量。
住院时间短暂，三分之一的人避免了住院。在住院和社区环境中均维持低剂量抗精神病药物治疗。患有躁狂性精神病的人更有可能住院。住院患者接受了更高剂量的抗精神病药物治疗，且在三个月随访时简明精神病评定量表精神病分量表得分的降低率更高。一个有代表性的子样本中80%对治疗有反应，到三个月结束时63%病情缓解。
这项自然主义研究表明，在一系列临床环境中实施EPPIC模式具有可行性，前景乐观且可应用于实践。
