Okasha A, Bishry Z, El Fiki M R, El Dawla A S, El Rasheed A H
Institute of Psychiatry, Ain Shams University, Cairo, Egypt.
J Clin Psychiatry. 2000 Oct;61(10):729-36. doi: 10.4088/jcp.v61n1004.
Schizophrenic patients and family members often retrospectively report having observed a number of nonpsychotic symptoms and/or certain alterations in behavior that they believe preceded any psychotic symptoms and behavior. The identification of possible relapse before its actual occurrence and the timely intervention in management are expected to spare both patient and family the suffering and pain of a full schizophrenic episode. The aim of this study was to determine if prodromal symptoms could be used as valid predictors of relapse in schizophrenic disorders and the relative diagnostic values of these symptoms in a sample of Egyptian schizophrenic patients.
One hundred Egyptian patients with schizophrenic disorders (DSM-III-R criteria) that had recently relapsed were retrospectively assessed for prodromal symptoms in the month preceding relapse. They were compared with 2 control groups, 50 Egyptian nonrelapsing schizophrenic patients and 50 healthy Egyptian individuals.
Nonpsychotic symptoms were the most common prodromal symptoms occurring in relapsing patients. A significant difference in frequency of prodromal symptoms was found for relapsing patients versus nonrelapsing patients (p < .001) and healthy controls (p < .05). Prodromal symptoms appear to have a relatively specific value for predicting subsequent psychotic symptoms in those subjects who previously experienced such symptoms.
Clusters of nonspecific prodromal symptoms exist that significantly differentiate between relapsing, nonrelapsing, and healthy controls. Fine-tuning of the identification of these symptoms could be a plausible clinical tool to be used by psychiatrists and general practitioners alike to predict a possibility of an impending relapse.
精神分裂症患者及其家属常常回顾性地报告称,他们观察到在出现任何精神病性症状和行为之前,存在一些非精神病性症状和/或行为的特定改变。在实际复发之前识别可能的复发情况,并及时进行管理干预,有望使患者及其家属免受精神分裂症全面发作带来的痛苦。本研究的目的是确定前驱症状是否可作为精神分裂症复发的有效预测指标,以及这些症状在一组埃及精神分裂症患者样本中的相对诊断价值。
对100名近期复发的符合精神分裂症(DSM-III-R标准)的埃及患者,回顾性评估其复发前一个月的前驱症状。将他们与2个对照组进行比较,50名未复发的埃及精神分裂症患者和50名健康的埃及人。
非精神病性症状是复发患者中最常见的前驱症状。复发患者与未复发患者(p < .001)及健康对照者(p < .05)在前驱症状出现频率上存在显著差异。前驱症状似乎对预测那些曾经历过此类症状的受试者随后出现的精神病性症状具有相对特定的价值。
存在非特异性前驱症状群,它们能显著区分复发患者、未复发患者和健康对照者。对这些症状识别方法的微调,可能成为精神科医生和全科医生预测即将复发可能性的一种可行临床工具。