Adachi Mental Clinic, Sapporo, Japan.
Epilepsia. 2012 Jun;53(6):1088-94. doi: 10.1111/j.1528-1167.2012.03438.x. Epub 2012 Mar 16.
There have been few reports showing the distribution of the duration of interictal psychosis (IIP) episodes and their association with clinical characteristics. To clarify the nature of IIP, we studied the duration of IIP episodes and their related factors.
One hundred fifty-five patients with epilepsy exhibited 320 IIP episodes during our follow-up period (mean 16.9 years). The duration of all the episodes and the longest episode in each patient during the follow-up periods were studied. Characteristics of the patients (e.g., epilepsy type, age of onset, and family history of psychosis) and episode-specific factors (e.g., age of the episode, seizure frequency, administrations of antiepileptic drugs [AEDs] and antipsychotic drugs [APDs]) were analyzed in association with the duration of the episodes.
Mean duration of the 320 IIP episodes was 82.7 weeks and that of the longest IIP episodes was 150.1 weeks. During the follow-up period, 17 patients (11.0%) showed all episodes remitting within a month and 54 (34.8%) showed all episodes lasting for 6 months or longer. The IIP episodes that occurred at a younger age were often prolonged. Patients with a family history of psychosis or with early onset of psychosis tended to have more prolonged IIP episodes. Among the episodes treated with APDs, early administration of APDs was significantly associated with shorter IIP duration.
The distribution of the duration of IIP episodes indicated the broad spectrum and heterogeneity of the IIP phenomena. The individual vulnerability to psychosis may be associated with prolonged episodes. Administration of APDs soon after onset of the episodes appeared to be effective in controlling them. These findings support empirical treatment principles for IIP to administer APDs at an early stage of its development.
鲜有研究报告显示发作间期精神病（IIP）发作的持续时间及其与临床特征的关系。为了阐明 IIP 的性质，我们研究了 IIP 发作的持续时间及其相关因素。
在我们的随访期间，155 例癫痫患者出现了 320 次 IIP 发作（平均 16.9 年）。研究了所有发作的持续时间和每位患者在随访期间最长的发作。分析了患者的特征（例如，癫痫类型、发病年龄和精神病家族史）和发作特异性因素（例如，发作年龄、发作频率、抗癫痫药物 [AED] 和抗精神病药物 [APD] 的使用）与发作持续时间的关系。
320 次 IIP 发作的平均持续时间为 82.7 周，最长 IIP 发作的持续时间为 150.1 周。在随访期间，17 名患者（11.0%）所有发作在一个月内缓解，54 名患者（34.8%）所有发作持续 6 个月或更长时间。年龄较小的 IIP 发作往往持续时间较长。有精神病家族史或精神病发病较早的患者往往有更长的 IIP 发作。在接受 APD 治疗的发作中，APD 的早期使用与 IIP 持续时间较短显著相关。
IIP 发作持续时间的分布表明 IIP 现象具有广泛的谱和异质性。个体对精神病的易感性可能与发作时间延长有关。在发作开始后尽早使用 APD 似乎对控制 IIP 有效。这些发现支持 IIP 的经验治疗原则，即在其发展的早期阶段使用 APD。
