Концепция раннего вмешательства в терапии шизофрении

Аннотация
Изучение закономерностей естественного и модифицированного антипсихотиками течения шизофрении показало, что наиболее высокая эффективность лечения наблюдается на ранних стадиях заболевания. Это позволило сформулировать концепцию раннего вмешательства, включающего в себя терапию на этапах продрома (ультравысокий риск развития психоза) и первого психотического эпизода. В настоящее время детально разработаны организационные, терапевтические и реабилитационные вопросы оказания помощи пациентам с первым психотическим эпизодом, однако вопрос об эффективности вмешательства на этапе продрома остается дискуссионным. Существующие инструменты оценки риска развития психоза у пациентов из группы ультравысокого риска недостаточно точны, а возможности антипсихотиков в профилактике манифестации шизофрении, как минимум, ограничены. Вследствие этого интерес исследователей сосредоточен на изучении возможностей немедикаментозных вмешательств (в частности, когнитивно-поведенческой терапии) на этапе продрома, а пациентам с первым психотическим эпизодом рекомендуется проведение активной антипсихотической терапии с ранним назначением внутримышечных пролонгированных антипсихотиков второго поколения, позволяющей добиться максимального полной редукции симптоматики и восстановления социального функционирования.
Ключевые слова
шизофрения, раннее вмешательство, ультравысокий риск развития психоза, первый психотический эпизод, лечение шизофрении, пролонгированные внутримышечные антипсихотики
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