嚴重精神疾病前驅期高危險群之篩檢預防議題分析

Assay of Screening and Prevention Issues for High Risk Populations with Prodromes of Severe Mental Illness

多數嚴重精神疾病患者曾經有過一段前驅期之症狀特徵，在早期發現且早期治療的協助下，可以有效改善患者前驅期的症狀，延緩嚴重精神疾病的可能發病時間，或者甚至可能預防疾病的發生。本文目的為介紹嚴重精神疾病前驅期高危險族群，統整四個篩檢策略，包含家族疾病史參考、精神狀態高風險評估、多重關卡篩檢、以及觀察基本症狀；兩方面介入預防措施，包括心理社會介入與藥物治療；分析相關倫理議題與台灣護理人員於此議題扮演之三種角色：擔任篩檢評估者，篩檢工具建構者，以及預防介入措施提供者等。期望更加深化台灣精神衛生護理人員於嚴重精神疾病患者之健康促進預防之議題。

Before the appearance of specific psychotic symptoms, most individuals experience a period of prodromal symptoms associated with severe mental illness. Early intervention during this pre-psychotic phase may improve treatment outcomes, alter the natural course of disease, and prevent or delay mental disease onset. This paper aimed to synthesize four screening strategies (genetic high-risk populations selected by family history with mental illness, finding ultra-high-risk population, the close-in strategy, and the pre-psychotic phase by assessing basic symptoms); two intervention dimensions (psychosocial interventions and antipsychotic medicine); discussions of ethnic issues; and three Taiwanese nurses' roles (the role of assessment for screening, the role of development for screening tools, and the role of preventive intervention providers) to attain early diagnoses and prevention of mental illness. This article provides more information to advanced Taiwanese mental health nurses responsible to promote / enhance the health of patients with prodromes of severe mental illness.