前驱期精神分裂症 6 年期间初级保健的使用增加。
Increased use of primary care during 6 years of prodromal schizophrenia.
机构信息
Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
出版信息
Acta Psychiatr Scand. 2016 Sep;134(3):225-33. doi: 10.1111/acps.12600. Epub 2016 Jun 13.
BACKGROUND
Early diagnosis is important for the course of schizophrenia.
AIM
To investigate whether prodromal symptoms of schizophrenia lead to increased use of primary care.
METHOD
A register-based cohort study of 21 894 cases with incident schizophrenia and 437 880 matched controls.
RESULTS
Cases used daytime primary care 43% more than controls during the 6 years before diagnosis (IRR = 1.43; 95% CI: 1.39; 1.48) and 132% more during the last 2 months (IRR = 2.32; 95% CI: 2.27; 2.37), and 34% (IRR = 1.34; 95% CI: 1.23; 1.48) vs. 374% more for out-of-hours services (IRR = 3.74; 95% CI: 3.52; 3.98). Six years before index diagnosis, 30% of cases had at least one psychiatric contact without being diagnosed with schizophrenia, increasing to 75% 1 month before diagnosis.
CONCLUSION
Increased help-seeking behaviour was seen at least 6 years before index diagnosis, suggesting a 'window' for earlier diagnosis of prodromal schizophrenia.
背景
早期诊断对精神分裂症的病程很重要。
目的
研究精神分裂症前驱症状是否会导致初级保健的使用增加。
方法
一项基于登记的队列研究，纳入了 21894 例首发精神分裂症病例和 437880 名匹配对照。
结果
在诊断前 6 年，病例组日间使用初级保健的比例比对照组高 43%（IRR=1.43；95%CI：1.39；1.48），在最后 2 个月高 132%（IRR=2.32；95%CI：2.27；2.37），而在非工作时间使用的比例高 34%（IRR=1.34；95%CI：1.23；1.48）比高 374%（IRR=3.74；95%CI：3.52；3.98）。在指数诊断前 6 年，有 30%的病例至少有一次精神科接触但未被诊断为精神分裂症，在诊断前 1 个月增加到 75%。
结论
在指数诊断前至少 6 年就出现了寻求帮助行为增加的情况，这表明在出现前驱精神分裂症症状时，存在一个可以更早诊断的“窗口”。
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