Bertelsen Mette, Jeppesen Pia, Petersen Lone, Thorup Anne, Øhlenschlaeger Johan, Le Quach Phuong, Østergaard Christensen Torben, Krarup Gertrud, Jørgensen Per, Nordentoft Merete
Bispebjerg Hospital, Department of Psychiatry, and Copenhagen University Faculty of Health Science, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark.
Schizophr Res. 2009 Feb;107(2-3):173-8. doi: 10.1016/j.schres.2008.09.018. Epub 2008 Oct 22.
There is an ongoing debate as to whether psychosis is a progressively deteriorating illness or one of progressive amelioration. This paper aims at investigating the rate of recovery and institutionalization and predicting a continuous illness course in a descriptive prospective study of a sub-sample of the OPUS trial of 265 first-episode psychotic patients after five years. Recovery, defined as no psychotic or negative symptoms, living independently, GAF (f)>59, working or studying, was reached for 18% after five years, whereas 13% were institutionalized either at hospital or supported housing after five years. Male gender (OR 1.9, 95% CI 1.06 to 3.23), premorbid social functioning (OR 1.2, 95% CI 1.01 to 1.33), psychotic symptoms (OR 1.3, 95% CI 1.07 to 1.66), and negative symptoms (OR 1.3, 95% CI 1.01 to 1.67) were found to predict a continuous illness course at five-year follow-up. Rates of recovery and institutionalization contradict the assumption that the illness deteriorates progressively, since no changes in the rates are seen from two to five years.
关于精神病是一种进行性恶化的疾病还是一种进行性改善的疾病，目前仍存在争议。本文旨在对OPUS试验中265名首发精神病患者的子样本进行描述性前瞻性研究，调查其康复率和住院率，并预测其五年后的疾病持续进程。五年后，18%的患者实现了康复，定义为无精神病性或阴性症状、独立生活、总体功能评估（GAF）（功能）>59、工作或学习；而五年后，13%的患者在医院或支持性住房机构接受照料。研究发现，男性（比值比1.9，95%置信区间1.06至3.23）、病前社会功能（比值比1.2，95%置信区间1.01至1.33）、精神病性症状（比值比1.3，95%置信区间1.07至1.66）和阴性症状（比值比1.3，95%置信区间1.01至1.67）可预测五年随访时的疾病持续进程。康复率和住院率与疾病会逐渐恶化的假设相矛盾，因为从两年到五年，这些比率没有变化。
