University of Hawaii, Manoa, HI, USA.
Schizophr Res. 2011 Sep;131(1-3):24-30. doi: 10.1016/j.schres.2011.06.022. Epub 2011 Jul 20.
The "Attenuated Psychosis Syndrome" (APS, sometimes referred to as the "schizophrenia prodrome") is characterized by subthreshold psychotic-like symptoms and functional decline, and is often associated with significant disability. These symptoms may cause impairment and are of further interest due to their predictive relation to schizophrenia and other psychotic disorders. These symptoms currently are not represented in the diagnostic system for mental health, and it is unclear how they are conceptualized by relevant professionals. The current study surveyed a national sample (n=303) of clinical psychologists, psychiatrists, and general practitioners regarding their clinical appraisal of APS. Practitioners were asked to respond to vignettes representing three conditions: psychosis, subthreshold psychosis (indicating 'attenuated' psychosis symptoms), and no psychotic symptoms. Practitioners' responses suggested that APS is viewed consistently with a DSM-IV-TR defined mental disorder and that most clinicians may diagnose this condition as a full threshold psychotic disorder. Findings tentatively suggest that the inclusion of an attenuated psychosis symptoms category in the forthcoming DSM-5 may be helpful in improving diagnostic reliability and facilitating best practice among community practitioners.
“衰减精神病综合征”（APS，有时也称为“精神分裂症前驱期”）的特征是出现阈下类精神病症状和功能下降，常伴有明显的残疾。这些症状可能会导致损伤，并且由于它们与精神分裂症和其他精神病障碍有预测关系而引起进一步关注。目前，这些症状并未在精神健康诊断系统中得到体现，也不清楚相关专业人员如何对其进行概念化。本研究调查了全国范围内的临床心理学家、精神科医生和全科医生（n=303）对 APS 的临床评估。要求从业者对代表三种情况的案例进行回应：精神病、阈下精神病（表示“衰减”的精神病症状）和没有精神病症状。从业者的回应表明，APS 被一致视为 DSM-IV-TR 定义的精神障碍，并且大多数临床医生可能将这种情况诊断为完全阈限精神病障碍。研究结果初步表明，在即将出台的 DSM-5 中加入衰减精神病症状类别可能有助于提高诊断的可靠性，并促进社区从业者的最佳实践。
