Xu Lihua, Zhang Tianhong, Wang Jijun
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Arch Psychiatry. 2015 Feb 25;27(1):42-4. doi: 10.11919/j.issn.1002-0829.214178.
One of the most exciting trends in schizophrenia research is the shift in focus from treatment studies to studies about the early identification and prevention of schizophrenia. These studies have primarily focused on adolescents or young adults with prodromal symptoms or on clinically high-risk individuals who show similar impairments in cognitive and social functioning to those seen in individuals with schizophrenia and, thus, are considered at high risk of developing schizophrenia or other psychotic disorders. Some researchers have labeled this condition as psychosis risk syndrome (PRS). There are moves in some circles to re-define the condition as a disorder in its own right: the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders 5(th) edition (DSM-5), lists 'attenuated psychosis syndrome' (APS) in the appendix as a condition for further study. Individuals with PRS are certainly at higher risk of developing a psychotic disorder than those without PRS, but the majority of those with PRS do not subsequently develop a psychotic disorder, so we argue against the inclusion of PRS or APS as a subtype of schizophrenia spectrum disorder.
精神分裂症研究中最令人兴奋的趋势之一,是研究重点从治疗研究转向精神分裂症的早期识别和预防研究。这些研究主要集中于有前驱症状的青少年或年轻人,或临床上的高风险个体,这些个体在认知和社会功能方面表现出与精神分裂症患者类似的损害,因此被认为有很高的发展为精神分裂症或其他精神障碍的风险。一些研究人员将这种情况称为精神病风险综合征(PRS)。在一些领域,有人提议将这种情况重新定义为一种独立的疾病:美国精神病学协会的《精神疾病诊断与统计手册》第5版(DSM-5)在附录中列出了“轻度精神病综合征”(APS)作为有待进一步研究的病症。患有PRS的个体发展为精神障碍的风险肯定高于没有PRS的个体,但大多数患有PRS的人随后并未发展为精神障碍,因此我们反对将PRS或APS纳入精神分裂症谱系障碍的亚型。