docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2024-23-7-102-112docru-206Research ArticleОБЗОРЫREVIEWSПервый психотический эпизод: клинико-диагностические аспекты и терапевтические подходыThe First Psychotic Episode: Clinical, Diagnostic Aspects, and Therapeutic Approacheshttps://orcid.org/0000-0003-3471-5293ЧинаревВ. А.ChinarevV. A.

Чинарев Виталий Александрович — врач-психиатр, заведующий девятым мужским клиническим психиатрическим отделением первичного эпизода; ассистент кафедры психиатрии  

г. Челябинск

Chelyabinsk

v.chinarev@okspnb.ruhttps://orcid.org/0000-0002-5811-4428МалининаЕ. В.MalininaE. V.

Малинина Елена Викторовна — д. м. н., профессор, заведующая кафедрой психиатрии

г. Челябинск

Chelyabinsk

malinina.e@rambler.ruФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава России; ГБУЗ «Областная клиническая специализированная психоневрологическая больница № 1»РоссияSouth Ural State Medical University; Regional Clinical Specialized Neuropsychiatric Hospital No. 1Russian FederationФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РоссииРоссияSouth Ural State Medical UniversityRussian Federation202418022025237НЕВРОЛОГИЯ ПСИХИАТРИЯ102112Copyright © Чинарев В.А., Малинина Е.В., 20252025Чинарев В.А., Малинина Е.В.Chinarev V.A., Malinina E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/206Цель

Цель. Представить всесторонний современный анализ клинических, диагностических аспектов и терапевтических подходов при первом психотическом эпизоде. Научный обзор основан на релевантных публикациях, полученных путем избирательного поиска литературы в PubMed/MEDLINE, eLIBRARY.RU, РИНЦ, Google Scholar и других базах данных за последние 5 лет.

Основные положения

Основные положения. В последние десятилетия увеличилось количество научных исследований, демонстрирующих результативность ранней интервенции при первом психотическом эпизоде. Психоз связан с различными психическими нарушениями, включая расстройства шизофренического спектра (шизофрению, шизоаффективное, бредовое, шизофреноформное и кратковременное психотическое расстройства), биполярное расстройство, депрессию и манию с психотическими включениями. Распространенность неаффективных психотических расстройств в течение жизни составляет 1,94%, аффективных психотических расстройств — 0,59%. Первые проявления психоза часто приходятся на молодой возраст, что может привести к нарушениям в различных сферах жизни пациента, включая личную, семейную, профессиональную и общественную активность, а это, в свою очередь, создает дополнительную нагрузку на семью и общество. Раннее выявление и лечение психотических симптомов повышает эффективность терапии и улучшает прогноз заболевания. В то же время отсутствие своевременной медицинской помощи влияет на эффективность и длительность антипсихотическ ой терапии, может привести к увеличению риска повторных госпитализаций, снижению качества жизни пациента и в результате — к неблагоприятному исходу заболевания.

Заключение

Заключение. Социальная значимость проблемы определяется тем, что, согласно данным Всемирной организации здравоохранения, острый психоз находится на третьем месте среди наиболее инвалидизирующих заболеваний, а основные психотические расстройства уменьшают среднюю продолжительность жизни на 10 лет. Одним из основных направлений современной медицины является превентивно-сберегающая реабилитация, направленная на предотвращение повторных госпитализаций и улучшение социальной адаптации пациентов. Изучение взаимодействия различных аспектов возникновения, протекания и исходов первого психотического эпизода позволяет оценить динамику, действующие программы психосоциальной реабилитации и лечения заболевания.

Aim

Aim. To provide a comprehensive and up-to-date analysis of the clinical, diagnostic, and therapeutic aspects of the first psychotic episode, this scientific review was conducted. The review is based on relevant publications from PubMed/MEDLINE, eLIBRARY.RU, RSCI, Google Scholar, and other databases published over the last five years.

Key points In recent decades, there has been an increase in the number of scientific studies that demonstrate the effectiveness of early intervention for the first psychotic episode. Psychosis can be associated with various mental disorders, such as schizophrenic spectrum disorders, bipolar disorder, and depression with psychotic features. The prevalence of these disorders during a person's lifetime is approximately 1.94% for non-affective psychotic disorders and 0.59% for affective psychotic disorders. The first manifestations of psychosis can occur at a young age and can lead to difficulties in personal, family, professional, and social life. Early detection and intervention can improve treatment outcomes and prognosis.. At the same time, lack of timely medical care can affect the effectiveness and duration of antipsychotic therapy. This can lead to increased risk of hospitalizations, decreased quality of life, and an unfavorable outcome for the patient.

Conclusion

Conclusion. The social significance of the problem is determined by the fact that, according to the World Health Organization, acute psychosis is in third place among the most disabling diseases, and major psychotic disorders reduce the average life expectancy by 10 years. One of the main directions of modern medicine is preventive and life-saving rehabilitation aimed at preventing repeated hospitalizations and improving the social adaptation of patients. The study of the interaction of various aspects of the occurrence, course and outcome of the first psychotic episode allows us to assess the dynamics, current programs of psychosocial rehabilitation and treatment of the disease.

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The authors declare that there are no conflicts of interest present.