Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry, 4101 Bruderholz, Switzerland.
Schizophr Res. 2010 Feb;116(2-3):168-72. doi: 10.1016/j.schres.2009.10.001. Epub 2009 Oct 24.
To investigate the proportion of patients among subjects initially identified as fulfilling the ultra-high risk (UHR) criteria for psychosis using the Scale of Prodromal Symptoms (SOPS) who fully remitted after one year.
Seventy-two patients between 14 and 40 years who were referred to the Bruderholz Early Psychosis Outpatient Service in Switzerland and who met UHR criteria were included in the present study. At 1-year follow-up, data for 52 patients were available. Patients with transition to psychosis and patients with sustained UHR criteria were defined as 'cases', and patients with remission from UHR criteria as 'non-cases'. We compared clinical and socio-demographic characteristics between these two patient groups at baseline.
13.5% of the patients converted to full-blown psychosis within one year, one quarter displayed sustained UHR criteria, and 59.2% of the patients fully remitted from the initial UHR status. Outcome was independent of medication or treatment status. 'Cases' and 'non-cases' did not differ significantly on socio-demographic and clinical variables at baseline.
The chance of remission to a non-risk state was over fourfold higher than the chance of conversion to psychosis within a year of establishing UHR status. Our data underline that the commonly used symptoms to identify UHR patients are often transitory and may not capture the stable core of developing psychosis. This highlights the danger of provoking anxiety and stigmatization in mislabeled individuals and missing true at-risk patients who present features of the psychosis core, but who do not yet-or maybe never will-manifest positive symptoms.
调查使用前驱症状量表（SOPS）初步确定符合精神病超高风险（UHR）标准的受试者中，在一年后完全缓解的患者比例。
本研究纳入了 72 名年龄在 14 至 40 岁之间的瑞士 Bruderholz 早期精神病门诊服务机构转诊的患者，他们符合 UHR 标准。在 1 年随访时，52 名患者的数据可用。出现精神病转化和持续符合 UHR 标准的患者被定义为“病例”，而 UHR 标准缓解的患者被定义为“非病例”。我们比较了这两组患者在基线时的临床和社会人口统计学特征。
在一年内，13.5%的患者发展为全面精神病，四分之一的患者持续符合 UHR 标准，而 59.2%的患者从前驱 UHR 状态完全缓解。结果与药物或治疗状态无关。“病例”和“非病例”在基线时的社会人口统计学和临床变量上没有显著差异。
在确定 UHR 状态后的一年内，从风险状态缓解的可能性是转化为精神病的四倍多。我们的数据强调，用于识别 UHR 患者的常见症状往往是短暂的，可能无法捕捉到正在发展的精神病的稳定核心。这凸显了在错误标记的个体中引起焦虑和污名化以及错过表现出精神病核心特征但尚未出现阳性症状或可能永远不会出现阳性症状的真正高危患者的危险。
