Всемирная психиатрия. №2 2018

Выходя за пределы концепции «группы риска по психическому здоровью»: переход к трансдиагностической психиатрии

Patrick D. McGorry, Jessica A. Hartmann, Rachael Spooner, Barnaby Nelson

Orygen, The National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental Health, University of Melbourne, Parkville, Australia

Стр. 133-142

1858 просмотров

Опубликовано: 12 ноября 2018

Аннотация / Abstract

a:2:{s:4:"TEXT";s:65533:"a:2:{s:4:"TYPE";s:4:"HTML";s:4:"TEXT";s:87064:"Перевод: Шуненков Д.А. (Иваново) Редактура: к.м.н. Рукавишников Г.В. (Санкт-Петербург) Подход по определению «группы риска по состоянию психического здоровья» в развитии психоза являлся весьма продуктивной исследовательской парадигмой в течение последних 25 лет. В данной статье мы рассматриваем эту парадигму и обобщаем главные выводы на ее основе, которые включают в себя значимость данного фенотипа для будущих исходов психоза, а также для коморбидных, персистирующих или возникающих непсихотических расстройств. К ним также относятся доказательства того, что начало психотического расстройства может быть отсроченным в группе пациентов сверхвысокого риска (СВР), а какая-то часть развернутых психотических расстройств могут возникать при состояниях риска, не охваченных критериями СВР. Данная парадигма также выявила факторы риска и механизмы, участвующие в развитии психоза. Однако данные, полученные при помощи этой и схожих парадигм, указывают на необходимость разработки новых идентификационных и диагностических стратегий. Эти данные включают высокую распространенность и последствия психических расстройств у молодых людей, ограничения существующих диагностических систем и подходов определения риска, диффузный и нестабильный характер симптомов на ранних стадиях и их плюрипотентные, трансдиагностические траектории развития. Подход, который мы недавно приняли, исходит из модели клинического стадирования и является адаптацией оригинального метода по определению «группы риска по состоянию психического здоровья» с целью охвата более широкого спектра входных и выходных целевых синдромов. Этот подход опирается на ряд новых моделей и стратегий прогнозирования, учитывающих и отражающих динамичный характер психопатологии, таких как теория динамических систем, теория сетей и совместное моделирование. Главным является то, что более широкий трансдиагностический подход и повышение прогностической возможност...

Перевод: Шуненков Д.А. (Иваново) Редактура: к.м.н. Рукавишников Г.В. (Санкт-Петербург) Подход по определению «группы риска по состоянию психического здоровья» в развитии психоза являлся весьма продуктивной исследовательской парадигмой в течение последних 25 лет. В данной статье мы рассматриваем эту парадигму и обобщаем главные выводы на ее основе, которые включают в себя значимость данного фенотипа для будущих исходов психоза, а также для коморбидных, персистирующих или возникающих непсихотических расстройств. К ним также относятся доказательства того, что начало психотического расстройства может быть отсроченным в группе пациентов сверхвысокого риска (СВР), а какая-то часть развернутых психотических расстройств могут возникать при состояниях риска, не охваченных критериями СВР. Данная парадигма такж...

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Вход / Регистрация

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Выходя за пределы концепции «группы риска по психическому здоровью»: переход к трансдиагностической психиатрии

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ЖУРНАЛЫ

ИНТЕРАКТИВ

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ИЗДАНИЯ-ПАРТНЕРЫ

Выходя за пределы концепции «группы риска по психическому здоровью»: переход к трансдиагностической психиатрии

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