Uçok Alp, Polat Aslihan, Cakir Sibel, Genç Aysun
Istanbul Tip Fakültesi, Psikiyatri AD, Millet Street, Capa (34390), Istanbul, Turkey.
Eur Arch Psychiatry Clin Neurosci. 2006 Feb;256(1):37-43. doi: 10.1007/s00406-005-0598-2. Epub 2005 Jul 18.
The aim of this study was to identify the predictors of outcome at one year follow-up after the first psychotic episode of schizophrenia. Seventy-nine first-episode schizophrenia patients were assessed monthly with the Brief Psychiatric Rating Scale (BPRS), Scale for Assessment of Positive Symptoms (SAPS), and Scale for Assessment of Negative Symptoms (SANS) after discharge from their first hospitalization. Outcome measures were presence of relapse and rehospitalization, level of global functioning, employment status and severity of symptoms at one year. A total of 33% of the patients had a relapse, and 12.1% were rehospitalized during one year follow-up. Premorbid childhood functionality was worse in patients who had relapse, but there was no correlation between premorbid adjustment scores and BPRS, SANS and SAPS scores at one year. There was no difference in duration of untreated psychosis (DUP) between patients who had relapse and not; however, the patients who had double relapse, had longer DUP than those without relapse. The time period between discharge and rehospitalization was shorter in patients with longer DUP. Functionality in childhood and noncompliance to the treatment independently contributed to the relapse rate. Functionality in late adolescence independently contributed to the Global Assessment of Functioning (GAF) scale score at one year and the GAF score at discharge appeared as a predictor of employment. The results of the present study suggest that treatment compliance and early premorbid adjustment level seem to be important predictors of relapse rate in first episode schizophrenia.
本研究的目的是确定精神分裂症首次精神病发作后一年随访时预后的预测因素。79例首次发作的精神分裂症患者在首次住院出院后每月接受简明精神病评定量表（BPRS）、阳性症状评定量表（SAPS）和阴性症状评定量表（SANS）评估。预后指标包括复发和再次住院情况、整体功能水平、就业状况以及一年时的症状严重程度。在一年的随访期间，共有33%的患者复发，12.1%的患者再次住院。复发患者病前儿童期功能较差，但病前适应评分与一年时的BPRS、SANS和SAPS评分之间无相关性。复发患者与未复发患者的未治疗精神病持续时间（DUP）无差异；然而，复发两次的患者DUP比未复发患者更长。DUP较长的患者出院至再次住院的时间较短。儿童期功能和治疗依从性独立影响复发率。青春期后期功能独立影响一年时的功能总体评定量表（GAF）评分，出院时的GAF评分是就业的预测因素。本研究结果表明，治疗依从性和早期病前适应水平似乎是首次发作精神分裂症复发率的重要预测因素。
