临床流行病学首发精神病：1年结局及预测因素
Clinical epidemiologic first-episode psychosis: 1-year outcome and predictors.
作者信息
Simonsen E, Friis S, Haahr U, Johannessen J O, Larsen T K, Melle I, Opjordsmoen S, Rund B R, Vaglum P, McGlashan T
机构信息
Roskilde Psychiatric University Hospital Fjorden, Roskilde, Denmark.
出版信息
Acta Psychiatr Scand. 2007 Jul;116(1):54-61. doi: 10.1111/j.1600-0447.2006.00942.x.
OBJECTIVE
To describe 1-year outcome in a large clinical epidemiologic sample of first-episode psychosis and its predictors.
METHOD
A total of 301 patients with first-episode psychosis from four healthcare sectors in Norway and Denmark receiving common assessments and standardized treatment were evaluated at baseline, at 3 months, and at 1 year.
RESULTS
Substantial clinical and social improvements occurred within the first 3 months. At 1-year 66% were in remission, 11% in relapse, and 23% continuously psychotic. Female gender and better premorbid functioning were predictive of less severe negative symptoms. Shorter DUP was predictive for shorter time to remission, stable remission, less severe positive symptoms, and better social functioning. Female gender, better premorbid social functioning and more education also contributed to a better social functioning.
CONCLUSION
This first-episode sample, being well treated, may be typical of the early course of schizophrenia in contemporary centers.
目的
描述首次发作精神病的大型临床流行病学样本的1年转归及其预测因素。
方法
对来自挪威和丹麦四个医疗保健部门的301例首次发作精神病患者进行了评估，这些患者接受了常规评估和标准化治疗，评估时间点为基线、3个月和1年。
结果
在最初3个月内出现了显著的临床和社会功能改善。1年时，66%的患者病情缓解，11%复发，23%持续存在精神病性症状。女性以及病前功能较好可预测阴性症状较轻。发病至治疗间隔时间（DUP）较短可预测缓解时间较短、缓解状态稳定、阳性症状较轻以及社会功能较好。女性、病前社会功能较好和受教育程度较高也有助于社会功能更好。
结论
这个接受了良好治疗的首次发作样本可能代表了当代医疗中心精神分裂症早期病程的典型情况。
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