OPUS试验中首次就诊患者从分裂型障碍转变为精神障碍的转化率。一项综合治疗与标准治疗的随机临床试验。

Transition rates from schizotypal disorder to psychotic disorder for first-contact patients included in the OPUS trial. A randomized clinical trial of integrated treatment and standard treatment.

作者信息

Nordentoft Merete, Thorup Anne, Petersen Lone, Ohlenschlaeger Johan, Melau Marianne, Christensen Torben Østergaard, Krarup Gertrud, Jørgensen Per, Jeppesen Pia

机构信息

Bispebjerg Hospital, Department Psychiatry, Bispebjerg, Bakke 23, DK-2400 Copenhagen NV, Denmark.

出版信息

Schizophr Res. 2006 Mar;83(1):29-40. doi: 10.1016/j.schres.2006.01.002. Epub 2006 Feb 28.

DOI:10.1016/j.schres.2006.01.002

PMID:16504481

Abstract

BACKGROUND

Only a few randomized clinical trials have tested the effect on transition rates of intervention programs for patients with sub-threshold psychosis-like symptoms.

AIM

To examine whether integrated treatment reduced transition to psychosis for first-contact patients diagnosed with schizotypal disorder.

METHODS

Seventy-nine patients were randomized to integrated treatment or standard treatment. Survival analysis with multivariate Cox-regression was used to identify factors determinant for transition to psychotic disorder.

RESULTS

In the multivariate model, male gender increased risk for transition to psychotic disorder (relative risk=4.47, (confidence interval 1.30-15.33)), while integrated treatment reduced the risk (relative risk=0.36 (confidence interval 0.16-0.85)). At two-year follow-up, the proportion diagnosed with a psychotic disorder was 25.0% for patients randomized to integrated treatment compared to 48.3% for patients randomized to standard treatment.

CONCLUSION

Integrated treatment postponed or inhibited onset of psychosis in significantly more cases than standard treatment.

摘要

背景

仅有少数随机临床试验检验了针对阈下精神病性症状患者的干预项目对转归率的影响。

目的

探讨综合治疗是否能降低首次诊断为分裂型障碍的初诊患者发展为精神病的比例。

方法

79名患者被随机分配至综合治疗组或标准治疗组。采用多变量Cox回归生存分析来确定发展为精神障碍的决定因素。

结果

在多变量模型中，男性发展为精神障碍的风险增加（相对风险=4.47，（置信区间1.30 - 15.33）），而综合治疗降低了该风险（相对风险=0.36（置信区间0.16 - 0.85））。在两年的随访中，随机分配至综合治疗组的患者中被诊断为精神障碍的比例为25.0%，而随机分配至标准治疗组的患者为48.3%。