지역사회 기반의 조기정신증 발견, 평가 및 배치 시스템 분석
The Analysis of Community-Based Identification, Assessment and Allocation System for Early Psychosis
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본 연구는 서울시 조기정신증 평가시스템의 현황 및 성과를 분석함으로써 지역사회를 기반으로 하는 조기발견 및 조기개입 서비스의 가능성과 문제점을 도출해 보고자 하였다. 본 시스템의 접촉자 중 정신과 치료가 필요한 대상자 발굴률 57% 및 정신보건서비스로의 연계율 70.3%라는 소기의 성과를 달성하기는 하였으나 임상적 고위험군의 발병정도 및 예후 등에 대한 결과를 제시하지 못하는 한계를 가지고 있다. 그럼에도 불구하고 지역사회 기반의 평가시스템의 필요성 및 발전방향을 제시함으로써 정책적으로 조기발견 및 조기개입체계를 구축하는데 초석을 마련했다고 볼 수 있으며 이를 바탕으로 다양한 후속 연구가 이루어 질 수 있는 기반을 마련하는데 의미가 있다고 하겠다.
Abstract
Objectives : The purpose of this study was to make empirical evidence of community based detection, assessment and allocation system for early psychosis. Methods : We analysed 222 youths who were referred to Seoul Early Management and Improvement Services (SEMIS) for early psychosis during six years from 2007 to 2012. Results : 44% of referrals were from suicide hotline, 23% from web-based SEMIS assessment program, 20% from other service areas such as military services and 11% were self referred. Among 222 youths, 139 (62.6%) were completed Structured Interview for Prodromal Syndrome (SIPS). After SIPS, 23% had untreated or early psychosis, another 17% were found to be at high risk of psychosis and 18% of completed SIPS were found to have other mental illness such as depression, yielding an efficiency ratio of 58%. 70% of youths who were categorized as psychosis or high risk of psychosis or other mental illness were referred to psychiatric hospital or case management services. Conclusion : This study shows the effectiveness and limitations of community-based assessment and intervention system for early psychosis. Integrated community program is necessary to improve the efficiency of early intervention and for the better outcomes.
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