过渡率到精神分裂症和早期干预在物质诱导和短暂的精神病障碍的有效性:一个随机对照试验
Mohamed Abouzed1, Amgad Gabr2, Mohamed Elsheikh2
1Psychiatry Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. dr_m.abozeid@azhar.edu.eg.
Scientific reports
|November 18, 2025
概括
专业早期干预 (SEI) 显著降低了近期发病精神障碍的个体的精神分裂症转变率39%. 这种包括精神教育和CBT在内的综合方法,为早期预防精神病提供了一个有希望的策略.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
背景情况:
- 最近出现的精神障碍,包括物质诱导精神障碍 (SIPD) 和短暂的精神障碍 (BPD),具有过渡到精神分裂症的重大风险.
- 早期识别和干预对于改善最初精神病发作的人的结果至关重要.
- 使用物质,特别是大麻,是与SIPD中更高的过渡率相关的显著风险因素.
研究的目的:
- 评估专业早期干预 (SEI) 在降低过渡到精神分裂症的速度方面的有效性.
- 为了比较SIPD和BPD之间的过渡率,并确定转换的预测因素.
- 评估多组分干预对长期精神病障碍发展的影响.
主要方法:
- 一个多站点,前性随机受控试验,涉及1000名参与者 (16-40岁) 患有近期SIPD或BPD.
- 参与者被随机分配到SEI (家庭精神教育,CBT,低剂量Risperidone) 或通常治疗 (TAU).
- 随访时间长达2年,首要结果是转变为精神分裂症,并对预测因素进行分析.
主要成果:
- 随访2年后,整体转变为精神分裂症的比例为26.3%.
- 过渡率在SIPD (29.1%) 中高于BPD (20.4%),与大麻相关的SIPD显示最高率 (38.1%).
- 与TAU相比,SEI在过渡到精神分裂症的风险下降了39% (HR=0.61,p=0.008).
结论:
- 一个全面的,多组件的SEI可以有效地减少最近出现精神疾病的个体过渡到精神分裂症.
- 神经认知缺陷,严重的阳性症状和高的炎症标志物是转换的重要预测因素.
- 这些发现强调了针对性,早期预防策略对于患精神分裂症高风险的个体的重要性.
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