NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University - Rome School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy.
Early Interv Psychiatry. 2013 May;7(2):187-92. doi: 10.1111/j.1751-7893.2012.00376.x. Epub 2012 Jul 4.
Disorders usually first diagnosed in infancy, childhood or adolescence (DUFD-ICA) may have preceded the onset of psychosis by several years and share some co-morbidity with psychotic disorders, but only a few studies have investigated this aspect. We looked for past or current DUFD-ICA in a sample of first adult psychiatric service users assessed for the presence of an at-risk mental state with the Structured Interview for Psychosis-risk Syndromes (SIPS).
We interviewed with the SIPS 159 first-time help seekers (age range 13-30 years) at adult psychiatric services who volunteered to participate in the study. For psychiatric diagnoses, we used the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition-Text Revision. We also assessed retrospectively the presence of DUFD-ICA and administered the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning. The sample has been subdivided diagnostically into first-episode psychosis, multiple episode psychosis, ultra-high risk (UHR) and other diagnoses.
The risk for having one of first-episode psychosis, multiple episode psychosis or UHR was over 3.45 higher in the DUFD-ICA-positive history group than in the non-DUFD-ICA. Grouping the UHR with the not full-blown psychosis cases resulted in a further increase of the risk to 4.71. DUFD-ICA-positive participants scored higher than non-DUFD-ICA on the Positive, Negative and Disorganization scales of the SIPS and on several core-psychotic BPRS items.
A positive history of DUFD-ICA increases the risk of a diagnosis of prodromal or current psychosis at help seeking. Impaired neurodevelopment may be shared among the psychoses and DUFD-ICA.
通常在婴儿期、儿童期或青春期首次诊断的疾病（DUFD-ICA）可能在精神病发作前数年就已经存在，并与精神病性障碍有一些共同的合并症，但只有少数研究对此进行了调查。我们在首次接受成人精神病服务的患者样本中寻找过去或现在的 DUFD-ICA，这些患者使用精神病风险综合征结构化访谈（SIPS）评估是否存在高危精神状态。
我们对 159 名首次寻求帮助的成年精神病服务患者进行了 SIPS 访谈（年龄范围为 13-30 岁），这些患者自愿参加了研究。对于精神疾病诊断，我们使用了《精神障碍诊断与统计手册》第 4 版修订版（DSM-IV-TR）。我们还回顾性评估了 DUFD-ICA 的存在情况，并进行了简短精神病评定量表（BPRS）和总体功能评估。该样本根据诊断分为首发精神病、多次发作精神病、超高危（UHR）和其他诊断。
在 DUFD-ICA 阳性病史组中，首发精神病、多次发作精神病或 UHR 的风险是 DUFD-ICA 阴性病史组的 3.45 倍以上。将 UHR 与非完全精神病病例分组，风险进一步增加到 4.71。在 SIPS 的阳性、阴性和紊乱量表以及一些核心精神病 BPRS 项目上，DUFD-ICA 阳性组的得分高于非 DUFD-ICA 阳性组。
DUFD-ICA 的阳性病史会增加在寻求帮助时诊断前驱或当前精神病的风险。神经发育障碍可能在精神病和 DUFD-ICA 中共同存在。
