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青年精神病超高危人群的症状和功能结局:一项纵向研究。

Symptomatic and functional outcome in youth at ultra-high risk for psychosis: a longitudinal study.

机构信息

Department of Psychology, University of Oviedo, Spain.

出版信息

Schizophr Res. 2009 Dec;115(2-3):121-9. doi: 10.1016/j.schres.2009.09.011. Epub 2009 Sep 27.

Abstract

The current report assesses the clinical, functioning and demographic data of a cohort enrolled in the P3 prevention program for psychosis; a Spanish National Health System and Ministry of Science funded program. Comparisons are made between those individuals who had converted to psychosis and those who had not at 3years after an average of 24 treatment sessions. Subjects included 61 participants meeting Structured Interview for Prodromal Syndromes criteria, with ages ranging from 17 to 31, and all meeting criteria for ultra-high risk of psychosis. Prospective follow-up data are reported for patients re-evaluated at 1 and 3years. At 1-year follow-up, the conversion rate to psychosis was 18%, but increased to 23% at 3-year follow-up. The converted sample was older than the non-converted sample and more likely to have higher ratings on subsyndromal psychotic (positive and disorganized), negative and general symptoms, and lower levels of functioning at baseline assessment. Analyses of change over time indicated a clear clinical improvement in both clinically stable patients and in those who showed a transient psychotic state over time. No gender differences in symptom or functioning levels at the three follow-up time points were found; however, the interactions among conversionxgenderxSOPS total scorextime points significantly reflect that the growth profiles of the four groups (no conversion males, no conversion females, conversion males and conversion females) in the SOPS total score are not parallel and that, consequently, the four groups involved different patterns of change over time, males experiencing faster and longer deterioration when psychotic symptoms arise.

摘要

本报告评估了参加精神病预防计划(P3)的队列的临床、功能和人口统计学数据;这是一个由西班牙国家卫生系统和科学部资助的项目。将在平均 24 次治疗后 3 年时发生精神病转化的人和未发生转化的人进行比较。研究对象包括 61 名符合前驱期综合征结构化访谈标准的参与者,年龄在 17 至 31 岁之间,均符合精神病超高风险标准。报告了对重新评估的患者进行的 1 年和 3 年的前瞻性随访数据。在 1 年的随访中,精神病转化率为 18%,但在 3 年的随访中增加到 23%。转化组的年龄大于未转化组,并且在基线评估时更有可能出现亚综合征精神病(阳性和紊乱)、阴性和一般症状的更高评分以及较低的功能水平。随着时间的推移,分析表明,无论是在临床稳定的患者中还是在随着时间的推移表现出短暂精神病状态的患者中,都有明显的临床改善。在三个随访时间点,未发现症状或功能水平存在性别差异;然而,转换 x 性别 x SOPS 总分 x 时间点之间的交互作用显著反映了四个组(无转换男性、无转换女性、转换男性和转换女性)的 SOPS 总分增长曲线并不平行,因此,这四个组涉及到不同的随时间变化的模式,当出现精神病症状时,男性的恶化速度更快、持续时间更长。

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