Rapado-Castro Marta, McGorry Patrick D, Yung Alison, Calvo Ana, Nelson Barnaby
Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia; Melbourne Neuropsychiatry Centre, The University of Melbourne, Victoria, Australia; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Insitituto de Investigacion Sanitaria Gregorio Marañon, IiSGM, CIBERSAM, Madrid, Spain.
Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia.
Schizophr Res. 2015 Jun;165(1):15-21. doi: 10.1016/j.schres.2015.03.022. Epub 2015 Apr 16.
Substantial controversy has been generated since the proposal to include "Attenuated Psychosis Syndrome" in DSM-5, based on research criteria used to identify young people at "ultra high risk" (UHR) for psychosis. The syndrome was ultimately included in the section for further research. The criteria specified that the person experienced attenuated psychotic symptoms (APS) that were sufficiently distressing to warrant clinical attention. Although APS are the main means of determining whether a person meets UHR criteria, clinical experience suggests that such symptoms are often not the main source of clinical distress in this patient group. However, little is known about the sources of distress in the UHR group. We aimed to assess the main sources of clinical distress in UHR patients at the time of referral to a specialized UHR clinic.
Sources and intensity of distress in 73 UHR patients were gathered from treating clinicians. The association with transition to psychosis was explored.
Of the total sample, 89.04% fulfilled the APS UHR criteria. APS symptoms were reported to be distressing for 58.5% of this subsample, but social and functioning difficulties (78.1%) and depressive symptoms (58.9%) were the highest sources of distress leading UHR patients to seek help. Intensity of distress associated with APS, anxiety symptoms and substance use was associated with transition to psychosis.
APS were reported to be distressing for approximately half of UHR patients. The intensity of distress associated to these symptoms may be associated with increased risk for subsequent transition to full threshold psychotic disorder.
自提议将“精神病性症状衰减综合征”纳入《精神疾病诊断与统计手册》第5版（DSM - 5）以来，基于用于识别处于精神病“超高风险”（UHR）的年轻人的研究标准，引发了大量争议。该综合征最终被纳入进一步研究部分。标准规定，个体经历的精神病性症状衰减（APS）足以令人痛苦，需要临床关注。虽然APS是确定一个人是否符合UHR标准的主要手段，但临床经验表明，这些症状在该患者群体中往往不是临床痛苦的主要来源。然而，对于UHR群体中痛苦的来源知之甚少。我们旨在评估转诊至专门的UHR诊所时UHR患者临床痛苦的主要来源。
从治疗医生处收集73名UHR患者痛苦的来源和强度。探讨其与向精神病转变的关联。
在总样本中，89.04%符合APS的UHR标准。据报告，该子样本中有58.5%的人认为APS症状令人痛苦，但社交和功能困难（78.1%）以及抑郁症状（58.9%）是导致UHR患者寻求帮助的最高痛苦来源。与APS、焦虑症状和物质使用相关的痛苦强度与向精神病的转变有关。
据报告，约一半的UHR患者认为APS令人痛苦。与这些症状相关的痛苦强度可能与随后转变为完全阈值精神病性障碍的风险增加有关。
