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פסיכיאטריה

First-Episode Psychosis

הרצאה מתוך הכינוס ה-155 של האגודה הפסיכיאטרית האמריקאית:

As more effective interventions for schizophrenia are being developed, the course of the disorder early on has become increasingly important. Several studies are underway on first-episode psychosis in Canada. Coldham and colleagues[1] presented their data on 200 patients in a study relating to treatment adherence in first-episode psychosis. Most patients in their First Episode Study suffered from schizophrenia; however, patients with schizophreniform disorder, schizoaffective disorder, delusional disorder, and other nonaffective psychoses were also included. Adherence to treatment was assessed on a 3-point scale. A total of 42% of the sample were considered to be nonadherent, 19% were rated as inadequately adherent, and 39% were considered adherent. Nonadherent patients manifested significantly more positive symptoms compared with both the inadequately adherent and adherent groups. The inadequately adherent cohort had more relapses than the adherent group, while the adherent group abused less alcohol and cannabis than both other groups. The nonadherent group demonstrated less insight into their disorder and had decreased quality-of-life scores. They tended to be younger and have an earlier age of onset of illness. Family members in the nonadherent cohort were less likely to be involved in treatment. These factors may be secondary to the disease process or to treatment nonadherence. The results are consistent with several other studies reported in the literature, and treatment strategies should be designed to address these issues to maximize treatment effectiveness in this vulnerable population.

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