Department of Psychosis Studies, Institute of Psychiatry, King's College, King's Health Partners, De Crespigny Park, 103 Denmark Hill, London SE5 8AF, UK.
Schizophr Bull. 2012 Mar;38(2):351-9. doi: 10.1093/schbul/sbq088. Epub 2010 Aug 12.
The at-risk mental state (ARMS) is associated with a very high risk of psychosis, but it is difficult to predict which individuals will later develop psychosis on the basis of their presenting symptoms. We investigated psychopathological dimensions in subjects with an ARMS and examined whether particular symptom dimensions predicted subsequent transition to psychosis.
The sample comprised 122 subjects (aged 16-35 years) meeting Personal Assessment and Crisis Evaluation clinic criteria for the ARMS recruited through Outreach and Support in South London, a clinical service for people with an ARMS. A principal axis factor analysis was performed on symptom scores, obtained at presentation from the Comprehensive Assessment of the At-Risk Mental State, using Varimax rotation. The relationship between dimension scores and transition to psychosis during the following 24 months was then examined employing Cox regression analysis.
Factor analysis gave rise to a 5-factor solution of negative, anxiety, disorganization/cognitive, self-harm, and manic symptom dimensions, accounting for 37% of the total variance. Scores on the negative and on the disorganization/cognitive dimensions were associated with transition to psychosis during the follow-up period (P = 0.044 and P = 0.005, respectively).
The symptoms of the ARMS have a dimensional structure similar to that evident in patients with schizophrenia except for the positive symptom dimension. The association between scores on the disorganization/cognitive and negative dimensions and later transition is consistent with independent evidence that formal thought disorder, subjective cognitive impairments, and negative symptoms are linked to the subsequent onset of psychosis.
高危精神状态（ARMS）与极高的精神病风险相关，但基于其表现症状预测哪些个体将随后发展为精神病较为困难。我们研究了处于 ARMS 的个体的精神病理学维度，并检验了特定的症状维度是否预测随后向精神病的转变。
该样本包括通过南伦敦外展和支持服务招募的符合个人评估和危机评估诊所 ARMS 标准的 122 名受试者（年龄 16-35 岁）。使用方差极大旋转对综合高危精神状态评估中在初次就诊时获得的症状评分进行主成分因子分析。然后，使用 Cox 回归分析检验维度评分与接下来 24 个月向精神病转变之间的关系。
因子分析产生了一个由 5 个因子组成的阴性、焦虑、紊乱/认知、自伤和躁狂症状维度的解决方案，占总方差的 37%。阴性和紊乱/认知维度的分数与随访期间向精神病的转变有关（P=0.044 和 P=0.005）。
ARMS 的症状具有类似于精神分裂症患者的维度结构，除了阳性症状维度。紊乱/认知和阴性维度分数与后来的转变之间的关联与独立证据一致，即形式思维障碍、主观认知障碍和阴性症状与精神病的后续发作有关。
