Hlastala Stefanie A, McClellan Jon
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA.
J Child Adolesc Psychopharmacol. 2005 Jun;15(3):497-509. doi: 10.1089/cap.2005.15.497.
This study aimed to better characterize the phenomenology and diagnostic stability of youths that report atypical psychotic symptoms.
In a 2-year longitudinal follow-up study, youths reporting atypical psychotic symptoms (n = 20) were compared with youths with schizophrenia (n = 27) and youths with bipolar disorder with psychotic features (n = 22) on psychotic, dissociative, and general symptomatology, comorbid diagnoses, previous abuse, and overall functioning. Diagnoses were obtained using structured diagnostic interviews (i.e., the Structured Clinical Interview for DSM-IV and the Diagnostic Interview for Children and Adolescents).
None of the subjects reporting atypical psychotic symptoms went on to develop a classic psychotic illness by the year 2 follow-up. These subjects had significantly higher rates of abuse and dissociative symptoms, and were significantly more likely to receive a diagnosis of posttraumatic stress disorder (PTSD) or a depressive disorder than youths with schizophrenia or bipolar disorder.
Our findings suggest that youths with atypical, fleeting, or situationally specific hallucinations are more likely to have a mood or anxiety disorder (such as PTSD) than a current or prodromal psychotic illness.
本研究旨在更好地描述报告非典型精神病性症状的青少年的现象学特征及诊断稳定性。
在一项为期2年的纵向随访研究中，将报告非典型精神病性症状的青少年（n = 20）与精神分裂症青少年（n = 27）以及伴有精神病性特征的双相情感障碍青少年（n = 22）在精神病性、分离性及一般症状学、共病诊断、既往虐待情况及整体功能方面进行比较。诊断通过结构化诊断访谈获得（即《精神疾病诊断与统计手册第四版》结构化临床访谈和儿童及青少年诊断访谈）。
到随访第2年时，报告非典型精神病性症状的受试者均未发展为典型的精神病性疾病。这些受试者的虐待及分离性症状发生率显著更高，与精神分裂症或双相情感障碍青少年相比，他们更有可能被诊断为创伤后应激障碍（PTSD）或抑郁症。
我们的研究结果表明，出现非典型、短暂或情境特定性幻觉的青少年更有可能患有情绪或焦虑障碍（如PTSD），而非目前或前驱性的精神病性疾病。
