对早期精神病的干预措施进行比较:系统性审查和组件网络元分析
Ryan Williams1,2, Edoardo G Ostinelli3,4,5, Joel Agorinya6
1Department of Brain Sciences, Imperial College London, London, UK.
EClinicalMedicine
|March 22, 2024
概括
心理干预和病例管理显著改善了早期精神病的结果. 这些成分与药物治疗一起,是早期干预服务中持续临床益处的关键.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 基于证据的医学基于证据的医学.
背景情况:
- 精神病早期干预 (EIP) 服务旨在改善早期精神病患者的治疗结果.
- 然而,EIP服务的异质性及其不同的治疗组件在理解持续治疗效果方面带来了挑战.
- 特定EIP服务组件对长期结果的影响仍然不清楚.
研究的目的:
- 系统地审查和分析专门的早期精神病干预服务中不同组件的有效性.
- 确定哪些治疗成分在改善早期精神病患者的结果方面最有效.
- 为优化EIP服务提供提供基于证据的建议.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和组件网络元分析 (cNMA).
- 在多个数据库 (CENTRAL,EMBASE,MEDLINE,CINAHL,PsycINFO,Web of Science) 进行了搜索,截至2023年2月.
- 主要结局包括在3个月和1年随访时出现的积极和消极精神病症状,以及治疗中断.
主要成果:
- 纳入了37个具有4599名参与者的RCT. 心理干预措施在3个月后减少负面症状,并在1年后改善社会功能方面显示出好处.
- 在1年的随访中,增加病例管理显著减少了消极和积极的精神病症状.
- 药物治疗是所有包含的试验组的一个组成部分,排除了对其特定效应的分析.
结论:
- 心理干预和病例管理,与药物治疗结合,似乎是实现早期精神病服务中持续临床益处的关键组成部分.
- 这些发现强调了EIP中综合治疗方法的重要性.
- 局限性包括研究数量少,连接网络稀疏,需要谨慎解释.
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