Kim Minah, Lee Tae Young, Lee Suji, Kim Sung Nyun, Kwon Jun Soo
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
Institute of Human Behavioral Sciences, Seoul National University-Medical Research Center, Seoul, Republic of Korea.
Schizophr Res. 2015 Jul;165(2-3):138-44. doi: 10.1016/j.schres.2015.04.033. Epub 2015 May 5.
The aim of this study was to investigate whether P300 could predict the short-term prognosis of subjects at clinical high risk (CHR) for psychosis who do not convert to psychotic disorder (non-converters).
CHR subjects were examined with auditory P300 at baseline, and their clinical state was regularly assessed up to 2 years. 45 CHR non-converters were divided into remitter and non-remitter groups. Repeated-measures analysis of variance (ANOVA) was performed to compare baseline P300 between the two groups. Multiple regression analysis was used to identify factors predicting symptomatic or functional improvement in CHR subjects during the follow-up period.
There were no group differences in P300 amplitude or latency between CHR remitters and non-remitters. In the multiple regression analysis, P300 amplitude at Pz (β=0.206, 95% confidence interval [95CI]=0.035 to 0.567, p=0.028) significantly predicted later amelioration of the Scale of Prodromal Symptoms (SOPS) negative symptoms. Improvement in SOPS general symptoms was significantly predicted by P300 amplitude at Pz (β=0.255, 95CI=0.065 to 0.455, p=0.010) and mood stabilizer use (β=0.199, 95CI=0.081 to 4.154, p=0.042).
These results indicate that P300 may be a possible predictor of improvement in negative and general symptoms in CHR non-converters. Our findings support the recommendation that a broader concept of assessment guidelines is needed to forecast clinical outcome and provide appropriate interventions for CHR non-converters.
本研究旨在调查P300是否能够预测临床高危（CHR）但未转化为精神障碍（未转化者）的受试者的短期预后。
在基线时对CHR受试者进行听觉P300检查，并对其临床状态进行长达2年的定期评估。45名CHR未转化者被分为缓解组和未缓解组。采用重复测量方差分析（ANOVA）比较两组之间的基线P300。多元回归分析用于确定预测CHR受试者随访期间症状或功能改善的因素。
CHR缓解者和未缓解者之间在P300波幅或潜伏期方面无组间差异。在多元回归分析中，Pz点的P300波幅（β=0.206，95%置信区间[95CI]=0.035至0.567，p=0.028）显著预测了前驱症状量表（SOPS）阴性症状的后期改善。Pz点的P300波幅（β=0.255，95CI=0.065至0.455，p=0.010）和使用心境稳定剂（β=0.199，95CI=0.081至4.154，p=0.042）显著预测了SOPS一般症状的改善。
这些结果表明，P300可能是CHR未转化者阴性和一般症状改善的一个可能预测指标。我们的研究结果支持这样的建议，即需要更广泛的评估指南概念来预测临床结果，并为CHR未转化者提供适当的干预措施。
