Larsen T K, Moe L C, Vibe-Hansen L, Johannessen J O
Psychiatric Hospital of Rogaland, Armauer Hansensv. 20, Stavanger, Norway.
Schizophr Res. 2000 Sep 29;45(1-2):1-9. doi: 10.1016/s0920-9964(99)00169-3.
This study examines 1year outcome in patients having first-episode non-affective psychosis, with emphasis on Duration of Untreated Psychosis (DUP) and premorbid functioning, in order to clarify how these factors interact.
Forty-three consecutively admitted patients were all rated on the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning Scale (GAF), both upon hospitalization and at 1year follow-up. In addition, premorbid functioning, DUP, duration of hospitalization, and social functioning were rated.
Fifty-six per cent were in remission, 18% suffered multiple relapses and 26% were continuously psychotic at 1 year follow-up. Both poor premorbid functioning and long DUP are significantly correlated with more negative symptoms and poorer global functioning at follow-up. Long DUP is also significantly correlated with more positive symptoms. Even when we control for other factors, including premorbid functioning and gender, DUP is a strong predictor of outcome. To a limited degree premorbid functioning and DUP interact, but DUP has an independent influence on outcome.
these findings strengthen the rationale for establishing health service programs for early detection and treatment of first-onset psychosis
本研究调查首次发作的非情感性精神病患者的1年预后情况，重点关注未治疗精神病持续时间（DUP）和病前功能，以阐明这些因素如何相互作用。
对43例连续入院的患者在住院时和1年随访时均进行阳性和阴性症状量表（PANSS）及总体功能评定量表（GAF）评定。此外，还对病前功能、DUP、住院时间和社会功能进行评定。
在1年随访时，56%的患者病情缓解，18%的患者多次复发，26%的患者仍有精神病症状。病前功能差和DUP长均与随访时更多的阴性症状及更差的总体功能显著相关。DUP长还与更多的阳性症状显著相关。即使我们控制了包括病前功能和性别在内的其他因素，DUP仍是预后的有力预测指标。病前功能和DUP在一定程度上相互作用，但DUP对预后有独立影响。
这些发现强化了建立早期发现和治疗首发精神病的卫生服务项目的理论依据。
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