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首发精神病患者的症状和功能缓解。

Symptomatic and functional remission in patients with first-episode psychosis.

机构信息

Department of Early Psychosis Intervention, Institute of Mental Health, Singapore, Singapore.

出版信息

Acta Psychiatr Scand. 2012 Oct;126(4):282-9. doi: 10.1111/j.1600-0447.2012.01883.x. Epub 2012 May 23.

Abstract

OBJECTIVE

For patients suffering from psychotic disorders and their caregivers, 'recovery' remains important. Our study aims to examine the rates of both symptomatic and functional remission in first-episode psychosis (FEP) patients at 2 years and identify sociodemographic and clinical factors associated with recovery.

METHOD

In this naturalistic study, all consecutive FEP patients presenting to an early psychosis intervention programme were recruited. Symptomatic remission was defined by the Schizophrenia Working Group's criteria; functional remission was defined as a Global Assessment of Functioning (GAF) disability score of ≥61 with engagement in age-appropriate vocation. Simple and multiple logistic regressions using stepwise method were used.

RESULTS

Out of 1175 patients, 636 (54.1%) met criteria for symptomatic remission, 686 (58.4%) for functional remission, while 345 (29.4%) met for both. Multiple logistic regression revealed female gender (OR 1.47; 95%CI, 1.12-1.93), those married (OR 1.49; 95%CI, 1.02-2.18), younger age (OR 0.98; 95%CI, 0.95-0.99), tertiary education (OR 1.56; 95%CI, 1.02-2.38), shorter DUP (OR 0.99; 95%CI, 0.98-0.99), lower baseline PANSS negative scores (OR 0.97; 95%CI, 0.95-0.99), and early response at month 3 (OR 1.78; 95%CI, 1.31-2.42), as significant predictors of recovery at year 2.

CONCLUSION

Our results indicate that strategies to reduce DUP and achieve early response could improve remission rates in FEP patients.

摘要

目的

对于患有精神障碍的患者及其照顾者,“康复”仍然很重要。我们的研究旨在检查首发精神病(FEP)患者在 2 年内症状和功能缓解的比率,并确定与康复相关的社会人口统计学和临床因素。

方法

在这项自然主义研究中,招募了所有出现于早期精神病干预计划的连续首发精神病患者。症状缓解定义为精神分裂症工作组标准;功能缓解定义为全球功能评估(GAF)残疾评分≥61 分,且从事适合年龄的职业。使用逐步法进行简单和多元逻辑回归。

结果

在 1175 名患者中,有 636 名(54.1%)符合症状缓解标准,686 名(58.4%)符合功能缓解标准,而 345 名(29.4%)同时符合两项标准。多元逻辑回归显示女性(OR 1.47;95%CI,1.12-1.93)、已婚(OR 1.49;95%CI,1.02-2.18)、年龄较小(OR 0.98;95%CI,0.95-0.99)、接受过高等教育(OR 1.56;95%CI,1.02-2.38)、较短的发病延迟期(OR 0.99;95%CI,0.98-0.99)、基线 PANSS 阴性评分较低(OR 0.97;95%CI,0.95-0.99)、第 3 个月早期反应(OR 1.78;95%CI,1.31-2.42)是第 2 年康复的显著预测因素。

结论

我们的研究结果表明,减少发病延迟期和实现早期反应的策略可能会提高 FEP 患者的缓解率。

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