Department of General and Social Psychiatry, Zurich University Psychiatric Hospital, University of Zurich, Switzerland.
Psychol Med. 2012 Jul;42(7):1461-73. doi: 10.1017/S0033291711002406. Epub 2011 Nov 21.
This study aimed to identify the course of unmet needs by patients with a first episode of schizophrenia and to determine associated variables.
We investigated baseline assessments in the European First Episode Schizophrenia Trial (EUFEST) and also follow-up interviews at 6 and 12 months. Latent class growth analysis was used to identify patient groups based on individual differences in the development of unmet needs. Multinomial logistic regression determined the predictors of group membership.
Four classes were identified. Three differed in their baseline levels of unmet needs whereas the fourth had a marked decrease in such needs. Main predictors of class membership were prognosis and depression at baseline, and the quality of life and psychosocial intervention at follow-up. Depression at follow-up did not vary among classes.
We identified subtypes of patients with different courses of unmet needs. Prognosis of clinical improvement was a better predictor for the decline in unmet needs than was psychopathology. Needs concerning social relationships were particularly persistent in patients who remained high in their unmet needs and who lacked additional psychosocial treatment.
本研究旨在确定首发精神分裂症患者未满足需求的发展过程，并确定相关变量。
我们调查了欧洲首发精神分裂症试验（EUFEST）的基线评估，以及 6 个月和 12 个月的随访访谈。使用潜在类别增长分析根据患者个体在未满足需求发展方面的差异来确定患者群体。多变量逻辑回归确定了群体归属的预测因素。
确定了四个类别。三个类别的未满足需求在基线水平上存在差异，而第四个类别的未满足需求明显减少。类别归属的主要预测因素是基线时的预后和抑郁，以及随访时的生活质量和心理社会干预。随访时的抑郁在各类别之间没有差异。
我们发现了未满足需求发展过程不同的患者亚型。与精神病理学相比，临床改善的预后是未满足需求下降的更好预测因素。在未满足需求较高且缺乏额外心理社会治疗的患者中，社会关系方面的需求尤为持久。
