青少年在使用心理健康服务时出现的类精神病体验和困扰。
Psychosis-like experiences and distress among adolescents using mental health services.
机构信息
University of Maryland, Baltimore County, Department of Psychology, United States.
University of Maryland, Baltimore, Department of Psychiatry, United States.
出版信息
Schizophr Res. 2014 Feb;152(2-3):498-502. doi: 10.1016/j.schres.2013.12.012. Epub 2014 Jan 8.
Although 'psychosis-like experiences' (PLEs) may reflect elevated risk for onset of serious mental illness, many individuals reporting PLEs are not truly at risk for developing clinical psychosis. Interview-based instruments that define and diagnose "clinical high risk" status attempt to distinguish between normative PLEs and attenuated symptoms indicating progression toward psychosis by probing whether such experiences create clinically relevant concerns. Two recently developed self-report measures, the Prodromal Questionnaire-Brief and the Prodromal Questionnaire-16, contain a 'distress scale' that helps assessors to gauge distress within a screening format. The aim of the current study is to examine the association of PLEs with distress within a sample of young people seeking mental health care and to investigate the usefulness of the distress scale in differentiating between participants who do and do not meet standardized criteria for a clinical high-risk syndrome. Sixty-six adolescents and young adults receiving mental health services completed the Prodromal Questionnaire-Brief and the Structured Interview for Psychosis Risk Syndromes. The screener was scored in ways that emphasized varying interpretations of respondents' distress ratings. Within this sample, focusing only on PLEs associated with distress yielded improved prediction of clinical high-risk status, and participants meeting high-risk clinical criteria were found to report more distress per PLE relative to participants with other psychiatric disorders. Findings suggest that including a distress scale within a screener aids in identifying a group more likely to meet clinical high-risk criteria. Further, PLEs that respondents describe as neutral or positive do not appear to be relevant for clinical high-risk screening.
虽然“类精神病体验”(PLEs)可能反映出发病严重精神疾病的风险增加,但许多报告 PLEs 的人实际上并没有发展为临床精神病的风险。基于访谈的工具定义和诊断“临床高风险”状态,试图通过探究这些体验是否产生临床相关的担忧,来区分正常的 PLEs 和预示向精神病发展的减弱症状。最近开发的两种自我报告量表,即前驱期问卷-简明版和前驱期问卷-16,包含一个“痛苦量表”,有助于评估者在筛查格式中评估痛苦。本研究的目的是在前瞻性队列研究中,在寻求心理健康服务的年轻人样本中,研究 PLEs 与痛苦之间的关系,并探讨痛苦量表在区分符合和不符合临床高风险综合征标准化标准的参与者方面的有用性。66 名接受心理健康服务的青少年和年轻人完成了前驱期问卷-简明版和精神病风险综合征结构化访谈。该筛选器的评分方式强调了对受访者痛苦评分的不同解释。在这个样本中,仅关注与痛苦相关的 PLEs 可以提高对临床高风险状态的预测,并且发现符合高风险临床标准的参与者相对于其他精神障碍患者,每出现一个 PLE 报告的痛苦更多。研究结果表明,在筛选器中包含痛苦量表有助于识别更有可能符合临床高风险标准的人群。此外,受访者描述为中性或阳性的 PLEs 似乎与临床高风险筛查无关。