不只是风险状态：高危精神病患者的功能和生活质量的荟萃分析。
Disorder, not just state of risk: meta-analysis of functioning and quality of life in people at high risk of psychosis.
机构信息
Paolo Fusar-Poli, PhD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and Outreach and Support in South London (OASIS) prodromal team, South London and the Maudsley National Health Service (NHS) Foundation Trust, London; Matteo Rocchetti, MD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK, and Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy; Alberto Sardella, PsyD, Alessia Avila, PsyD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Martina Brandizzi, MD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Professor, Pierluigi Politi, Professor, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, PhD, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Professor, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and OASIS prodromal team, South London and the Maudsley NHS Foundation Trust, London, UK
Paolo Fusar-Poli, PhD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and Outreach and Support in South London (OASIS) prodromal team, South London and the Maudsley National Health Service (NHS) Foundation Trust, London; Matteo Rocchetti, MD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK, and Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy; Alberto Sardella, PsyD, Alessia Avila, PsyD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Martina Brandizzi, MD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Professor, Pierluigi Politi, Professor, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, PhD, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Professor, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and OASIS prodromal team, South London and the Maudsley NHS Foundation Trust, London, UK.
出版信息
Br J Psychiatry. 2015 Sep;207(3):198-206. doi: 10.1192/bjp.bp.114.157115.
BACKGROUND
The nosology of the psychosis high-risk state is controversial. Traditionally conceived as an 'at risk' state for the development of psychotic disorders, it is also conceptualised as a clinical syndrome associated with functional impairment.
AIMS
To investigate meta-analytically the functional status of patients at high clinical risk for psychosis and its association with longitudinal outcomes.
METHOD
Three meta-analyses compared level of functioning (n = 3012) and quality of life (QoL) (n = 945) between a high-risk group, a healthy control group and group with psychosis, and baseline functioning in people in the high-risk group who did or did not have a transition to psychosis at follow-up (n = 654).
RESULTS
People at high risk had a large impairment in functioning (P<0.001) and worse QoL (P = 0.001) than the healthy control group, but only small to moderately better functioning (P = 0.012) and similar QoL (P = 0.958) compared with the psychosis group. Among the high-risk group, those who did not develop psychosis reported better functioning (P = 0.001) than those who did.
CONCLUSIONS
Our results indicate that the high-risk state is characterised by consistent and large impairments of functioning and reduction in QoL similar to those in other coded psychiatric disorders.
背景
精神病高危状态的分类学存在争议。传统上，它被认为是发展为精神病障碍的“风险”状态，也被认为是与功能障碍相关的临床综合征。
目的
通过荟萃分析研究精神病高危患者的功能状态及其与纵向结局的关系。
方法
三项荟萃分析比较了高风险组（n=3012）、健康对照组（n=945）和精神病组的功能水平和生活质量（QoL），以及在随访时发生或未发生精神病转化的高风险组患者（n=654）的基线功能。
结果
高风险人群的功能障碍（P<0.001）和生活质量（P=0.001）明显受损，而与精神病组相比，仅表现出较小到中度的更好功能（P=0.012）和相似的生活质量（P=0.958）。在高风险组中，未发展为精神病的患者报告的功能更好（P=0.001）。
结论
我们的研究结果表明，高危状态的特点是功能障碍和生活质量下降持续且严重，与其他编码精神障碍相似。
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