Norman Ross M G, Malla Ashok K, Manchanda Rahul
Dept. of Psychiatry, University of Western Ontario, London (ON), Canada.
Soc Psychiatry Psychiatr Epidemiol. 2007 Jun;42(6):507-12. doi: 10.1007/s00127-007-0174-3. Epub 2007 May 18.
Recent evidence that treatment delay may compromise the potential for recovery from psychotic disorders has resulted in increased interest in factors that influence help seeking. In this paper, we test the hypotheses, derived from past research, that having a positive family history of a psychotic disorder in first or second degree relatives will be associated with a shorter duration of untreated psychosis (DUP), but a longer duration of untreated illness (DUI). Data were derived from 169 patients who presented for treatment to a first episode psychotic disorders program. Information was collected concerning family history, DUP, DUI and the timing of family recognition of the need for help.
The findings failed to confirm a positive family history being associated with shorter DUP, but did support the prediction of such a history being related to longer DUI. Paradoxically, given the latter findings, families with a history of psychotic illness were more likely to recognize the need for help for the ill person prior to the onset of psychotic symptoms. The difference in DUI appears to reflect the presence of a longer period of early signs prior to the emergence of psychosis in those cases with a positive family history.
These findings suggest the importance of examining family history as a possible confound of any relationship between DUI and long-term course of illness.
近期有证据表明，治疗延迟可能会损害精神障碍康复的潜力，这使得人们对影响求助行为的因素越来越感兴趣。在本文中，我们检验了基于以往研究得出的假设，即一级或二级亲属中有精神障碍的阳性家族史与未治疗精神病持续时间（DUP）较短相关，但与未治疗疾病持续时间（DUI）较长相关。数据来源于169名到首次发作精神障碍项目接受治疗的患者。收集了有关家族史、DUP、DUI以及家属认识到需要帮助的时间的信息。
研究结果未能证实阳性家族史与较短的DUP相关，但确实支持了这种家族史与较长的DUI相关的预测。矛盾的是，鉴于后一项发现，有精神疾病家族史的家庭在精神病症状出现之前更有可能认识到患病者需要帮助。DUI的差异似乎反映出，在有阳性家族史的病例中，精神病出现之前存在较长时间的早期症状。
这些发现表明，检查家族史作为DUI与疾病长期病程之间任何关系的可能混杂因素具有重要意义。
