Implementation of the modified NAVIGATE program for early schizophrenia in Shanghai through the specialized hospital and community integration: A comparative study.

IF 2.5 4区医学 Q2 PSYCHIATRY

International Journal of Social Psychiatry Pub Date : 2025-03-31 DOI:10.1177/00207640241311031

Lihua Wang, Huijie Lu, Yihua Jiang, Dianming Zhu, Ping Sun, Haiming Sun, Lanlan Wang, Wenhui Jiang, Yanru Wu, Zeping Xiao

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引用次数: 0

Abstract

Background: The modified NAVIGATE program for early schizophrenia, called the Recovery program, was implemented in the Minhang district of Shanghai, China, with a population of approximately 2.7 million, representing 11% of the city's population of about 24 million. The specialized hospital and communities integrated to form multidisciplinary treatment teams to provide multi-component treatment and services, and to receive group training and supervision together. The aim of the study is to evaluate and compare the effects of the Recovery program with conventional care on psychiatric symptoms and social functioning.

Method: A total of 128 participants with a diagnosis of schizophrenia, aged 15 to 40 years, and illness duration ⩽5 years were enrolled. Patients living in the Minhang district were assigned to the Recovery program, and those living in other districts of Shanghai received the conventional care. Patients were followed up at baseline and after 2, 4, 6, 8, 10, and 12 months with assessments of symptoms, social functioning, treatment adherence, relapse, community activities, and school/work attendance using the Positive and Negative Symptom Scale (PANSS), the Clinical Global Impression Scale (CGI), and the Personal Social Functioning Scale (PSP).

Results: Sixty-three participants receiving the Recovery program care showed greater improvement in psychotic symptoms and social functioning than 65 participants receiving conventional care. Participants in the Recovery program had lower rates of missed psychiatric visits >2 months (3.2% vs. 49.2%), antipsychotic discontinuation (7.9% vs. 36.9%), and relapse (4.8% vs. 26.2%) compared with conventional care.

Conclusions: The modified NAVIGATE program can be implemented in the Minhang district of Shanghai, China, through the integration of the specialized hospital and community, and improves clinical outcomes for patients with early schizophrenia compared to conventional care. It has great potential for implementation in other districts in China.

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通过专科医院和社区整合实施改进的导航方案治疗上海早期精神分裂症：比较研究。

背景：在中国上海闵行区实施了针对早期精神分裂症的修改后的导航计划，称为康复计划，该计划的人口约为270万，占该市约2400万人口的11%。专科医院与社区整合，组成多学科治疗团队，提供多成分治疗和服务，共同接受集体培训和监督。本研究的目的是评估和比较康复计划与传统护理对精神症状和社会功能的影响。方法：共纳入128名被诊断为精神分裂症的参与者，年龄在15至40岁之间，病程≥5年。居住在闵行区的患者被分配到康复方案，居住在上海其他地区的患者接受常规治疗。患者在基线和2、4、6、8、10和12个月后随访，使用阳性和阴性症状量表（PANSS）、临床总体印象量表（CGI）和个人社会功能量表（PSP）评估症状、社会功能、治疗依从性、复发、社区活动和学校/工作出勤率。结果：63名接受康复计划护理的参与者比65名接受常规护理的参与者在精神病症状和社会功能方面表现出更大的改善。与传统治疗相比，康复计划的参与者在2个月内有较低的精神科失诊率（3.2%对49.2%）、抗精神病药物停药率（7.9%对36.9%）和复发率（4.8%对26.2%）。结论：改进后的NAVIGATE方案可以在中国上海闵行区实施，通过专科医院和社区的整合，与传统护理相比，可以改善早期精神分裂症患者的临床结果。在中国其他地区有很大的推广潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Social Psychiatry PSYCHIATRY-

CiteScore

12.30

自引率

1.30%

发文量

120

期刊介绍： The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities. Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas. The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.