Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Sydney, New South Wales.
Early Interv Psychiatry. 2013 Feb;7(1):31-43. doi: 10.1111/j.1751-7893.2012.00366.x. Epub 2012 Jun 5.
The study aims to apply clinical staging to young people who present for mental health care; to describe the demographic features, patterns of psychological symptoms, disability correlates and clinical stages of those young people; and to report longitudinal estimates of progression from less to more severe stages.
The study uses cross-sectional and longitudinal assessments of young people managed in specialized youth clinics. On the basis of clinical records, subjects were assigned to a specific clinical 'stage' (i.e. 'help-seeking', 'attenuated syndrome', 'discrete disorder' or 'persistent or recurrent illness').
Young people (n = 209, mean age = 19.9 years (range = 12-30 years), 48% female) were selected from a broader cohort of n = 1483 subjects. Ten percent were assigned to the earliest 'help-seeking' stage, 54% to the 'attenuated syndrome' stage, 25% to the 'discrete disorder' stage and 11% to the later 'persistent or recurrent illness' stage. The interrater reliability of independent ratings at baseline was acceptable (κ = 0.71). Subjects assigned to the 'attenuated syndrome' stage reported symptom and disability scores that were similar to those assigned to later stages. Longitudinally (median = 48 weeks), transition to later clinical stages were 11% of the 'help-seeking', 19% of the 'attenuated syndrome' and 33% of the 'discrete disorder' groups.
Among young people presenting for mental health care, most are clinically staged as having 'attenuated syndromes'. Despite access to specialized treatment, a significant number progress to more severe or persistent disorders.
本研究旨在将临床分期应用于寻求心理健康护理的年轻人；描述这些年轻人的人口统计学特征、心理症状模式、残疾相关性和临床分期；并报告从较轻分期向较严重分期进展的纵向估计。
本研究使用专门的青年诊所管理的年轻人的横断面和纵向评估。根据临床记录，将受试者分配到特定的临床“分期”（即“寻求帮助”、“轻度综合征”、“离散障碍”或“持续或复发性疾病”）。
从更广泛的 n = 1483 名受试者中选择了 209 名年轻人（平均年龄 19.9 岁（范围 12-30 岁），48%为女性）。10%被分配到最早的“寻求帮助”阶段，54%被分配到“轻度综合征”阶段，25%被分配到“离散障碍”阶段，11%被分配到较晚的“持续或复发性疾病”阶段。基线时独立评分的组内信度是可以接受的（κ = 0.71）。被分配到“轻度综合征”阶段的受试者报告的症状和残疾评分与被分配到较晚阶段的受试者相似。纵向（中位数 = 48 周），向较晚的临床阶段过渡的比例分别为“寻求帮助”的 11%、“轻度综合征”的 19%和“离散障碍”的 33%。
在寻求心理健康护理的年轻人中，大多数被临床分期为“轻度综合征”。尽管获得了专门的治疗，但仍有相当数量的人病情恶化或持续存在。
