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首页> 外文期刊>Nordic journal of psychiatry. >Treatment of adult patients with schizophrenia and complex mental health needs - A national clinical guideline
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Treatment of adult patients with schizophrenia and complex mental health needs - A national clinical guideline

机译：成人精神分裂症和复杂精神健康需求患者的治疗-国家临床指南

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Background and aim: The Danish Health and Medicines Authority assembled a group of experts to develop a national clinical guideline for patients with schizophrenia and complex mental health needs. Within this context, ten explicit review questions were formulated, covering several identified key issues. Methods: Systematic literature searches were performed stepwise for each review question to identify relevant guidelines, systematic reviews/meta-analyses, and randomized controlled trials. The quality of the body of evidence for each review question was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Clinical recommendations were developed on the basis of the evidence, assessment of the risk-benefit ratio, and perceived patient preferences. Results: Based on the identified evidence, a guideline development group (GDG) recommended that the following interventions should be offered routinely: antipsychotic maintenance therapy, family intervention and assertive community treatment. The following interventions should be considered: long-acting injectable antipsychotics, neurocognitive training, social cognitive training, cognitive behavioural therapy for persistent positive and/or negative symptoms, and the combination of cognitive behavioural therapy and motivational interviewing for cannabis and/or central stimulant abuse. SSRI or SNRI add-on treatment for persistent negative symptoms should be used only cautiously. Where no evidence was available, the GDG agreed on a good practice recommendation. Conclusions: The implementation of this guideline in daily clinical practice can facilitate good treatment outcomes within the population of patients with schizophrenia and complex mental health needs. The guideline does not cover all available interventions and should be used in conjunction with other relevant guidelines.
机译：背景和目的：丹麦卫生与药品管理局召集了一个专家小组，以制定针对精神分裂症和复杂精神健康需求患者的国家临床指南。在此背景下，制定了十个明确的复习题，涵盖了几个已确定的关键问题。方法：针对每个复习问题逐步进行系统的文献检索，以鉴定相关指南，系统的复习/元分析和随机对照试验。使用“建议评估，发展和评估等级”（GRADE）系统对每个复习问题的证据质量进行评估。根据证据，风险收益率评估和患者的喜好来制定临床建议。结果：根据已确定的证据，指南制定小组（GDG）建议应定期进行以下干预：抗精神病药物维持治疗，家庭干预和自信的社区治疗。应考虑采取以下干预措施：长效抗精神病药，神经认知训练，社会认知训练，针对持续的积极和/或消极症状的认知行为疗法，以及针对大麻和/或中枢兴奋剂滥用的认知行为疗法与动机访谈相结合。对于持续的阴性症状，应谨慎使用SSRI或SNRI附加治疗。在没有证据的情况下，GDG同意了一项良好做法建议。结论：该指南在日常临床实践中的实施可以在精神分裂症和复杂精神健康需要的患者人群中促进良好的治疗效果。该指南未涵盖所有可用的干预措施，应与其他相关指南结合使用。

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