Kelleher Ian, Wigman Johanna T W, Harley Michelle, O'Hanlon Erik, Coughlan Helen, Rawdon Caroline, Murphy Jennifer, Power Emmet, Higgins Niamh M, Cannon Mary
Royal College of Surgeons in Ireland, Dept Psychiatry, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland.
University Medical Centre Groningen, Dept of Psychiatry, Groningen, The Netherlands.
Schizophr Res. 2015 Jun;165(1):9-14. doi: 10.1016/j.schres.2015.03.020. Epub 2015 Apr 11.
Psychotic experiences are far more common in the population than psychotic disorder. They are associated with a number of adverse outcomes but there has been little research on associations with functioning and distress. We wished to investigate functioning and distress in a community sample of adolescents with psychotic experiences. Two hundred and twelve school-going adolescents were assessed for psychotic experiences, mental distress associated with these experiences, global (social/occupational) functioning on the Children's Global Assessment Scale, and a number of candidate mediator variables, including psychopathology, suicidality, trauma (physical and sexual abuse and exposure to domestic violence) and neurocognitive functioning. Seventy five percent of participants who reported psychotic experiences reported that they found these experiences distressing (mean score for severity of distress was 6.9 out of maximum 10). Participants who reported psychotic experiences had poorer functioning than participants who did not report psychotic experiences (respective means: 68.6, 81.9; OR=0.25, 95% CI=0.14-0.44). Similarly, participants with an Axis-1 psychiatric disorder who reported psychotic experiences had poorer functioning than participants with a disorder who did not report psychotic experiences (respective means: 61.8, 74.5; OR=0.28, 95% CI=0.12-0.63). Candidate mediator variables explained some but not all of the relationship between psychotic experiences and functioning (OR=0.48, 95% CI=0.22-1.05, P<0.07). Young people with psychotic experiences have poorer global functioning than those who do not, even when compared with other young people with psychopathology (but who do not report psychotic experiences). A disclosure of psychotic experiences should alert treating clinicians that the individual may have significantly more functional disability than suggested by the psychopathological diagnosis alone.
精神病性体验在普通人群中比精神障碍更为常见。它们与许多不良后果相关，但关于其与功能及痛苦之间关联的研究却很少。我们希望对有精神病性体验的青少年社区样本的功能及痛苦状况进行调查。对212名在校青少年进行了评估，内容包括精神病性体验、与这些体验相关的精神痛苦、基于儿童总体评估量表的整体（社会/职业）功能，以及一些候选中介变量，包括精神病理学、自杀倾向、创伤（身体和性虐待以及遭受家庭暴力）和神经认知功能。报告有精神病性体验的参与者中，75%表示他们觉得这些体验令人痛苦（痛苦严重程度的平均分为6.9分，满分10分）。报告有精神病性体验的参与者比未报告有精神病性体验的参与者功能更差（各自的平均分：68.6，81.9；OR=0.25，95%CI=0.14 - 0.44）。同样，报告有精神病性体验的轴I精神障碍参与者比未报告有精神病性体验的该障碍参与者功能更差（各自的平均分：61.8，74.5；OR=0.28，95%CI=0.12 - 0.63）。候选中介变量解释了精神病性体验与功能之间部分而非全部的关系（OR=0.48，95%CI=0.22 - 1.05，P<0.07）。有精神病性体验的年轻人整体功能比没有的年轻人更差，即使与其他有精神病理学问题（但未报告有精神病性体验）的年轻人相比也是如此。精神病性体验的披露应提醒治疗临床医生，该个体可能存在比仅由精神病理学诊断所暗示的更为显著的功能残疾。
