Department of Psychiatry, Medical Faculty of Masaryk University and Faculty Hospital Brno, Brno-Bohunice, Czech Republic.
World J Biol Psychiatry. 2011 Feb;12(1):66-72. doi: 10.3109/15622975.2010.518625. Epub 2010 Nov 18.
The early course of schizophrenia is highly variable. We assessed outcomes of patients with first-episode schizophrenia at 7-year follow-up.
Consecutively hospitalized male patients were included if they were experiencing their first admission for first-episode schizophrenia and were reassessed at 1-, 4- and 7-year follow-ups. The psychopathology was evaluated using the PANSS, relative decrease of PANSS and remission status based on severity of core symptoms.
Forty-four of 76 patients were reassessed three times. At the end of index hospitalization 73% of patients achieved remission; however, after 1, 4 and 7 years, the percentage had dropped to 50, 50 and 52%, respectively. When compared post-hoc there was no significant difference in PANSS and response to treatment between remitters and non-remitters during the index hospitalization; however, a significant difference in psychopathology emerged first after 1, 4 and 7 years. All patients who had not achieve remission after 1 year also failed to achieve remission after 4 and 7 years.
Response to treatment during the first psychotic break-through may not be a decisive indicator for the outlook of the disease. Our data suggest that when deterioration occurs, it does so early after the first episode.
精神分裂症的早期病程变化多样。我们评估了首发精神分裂症患者在 7 年随访时的结局。
连续住院的男性患者，如果他们正在经历首发精神分裂症的首次入院，并且在 1 年、4 年和 7 年随访时接受重新评估，将被纳入研究。采用 PANSS 量表评估精神病理学，根据核心症状严重程度评估 PANSS 相对减少率和缓解状态。
76 例患者中有 44 例进行了 3 次重新评估。在指数住院期间，73%的患者达到缓解；然而，1 年后，缓解率下降至 50%，4 年后为 50%，7 年后为 52%。事后比较发现，缓解者和未缓解者在指数住院期间的 PANSS 评分和治疗反应无显著差异；然而，在 1 年、4 年和 7 年后，精神病理学出现了显著差异。所有在 1 年后未缓解的患者在 4 年和 7 年后也未能缓解。
首次精神病发作期间的治疗反应可能不是疾病预后的决定性指标。我们的数据表明，当病情恶化时，通常在首次发作后早期发生。
