Okasha Tarek, Zaki Nivert, Meguid Marwa Abd El, El-Missiry Marwa, Sabry Walaa, Ismaeil Mostafa Kamel, Fouad Samar M
WHO Collaborating Centre for Mental Health Research and Training, Institute of Psychiatry, Ain Shams University, Cairo, Egypt.
Int J Soc Psychiatry. 2016 Nov;62(7):661-671. doi: 10.1177/0020764016670429. Epub 2016 Sep 28.
Duration of untreated psychosis (DUP) has been considered as a poor prognostic factor for psychotic disorder. Several studies have been investigating different predictors of DUP in Western countries, while in Egypt only a few studies have examined various predictors of DUP.
To study DUP in Egyptian patients with psychotic disorders and to investigate how certain illnesses, patient, socio-cultural risk factors and help-seeking behaviour are correlated with prolonged DUP.
The sample included 100 patients with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) diagnosis of psychotic disorder were selected and interviewed to assess DUP. They were interviewed using the Structured Clinical Interview for DSM-IV axis I disorders (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) scale.
Mean (±standard deviation ( SD)) of DUP was found to be 36.93(±45.27) months. DUP was correlated with various sociodemographic and clinical variables. Following log transformation of DUP, correlation with PANSS scores was done and revealed highly significant statistical relation of DUP to PANSS negative and PANSS positive scores. In linear regression analysis, it was found that age of patients, the age of onset, residence, being illiterate, the insidious mode of onset, negative family history of psychiatric disorder and the severity of illness as indicated by PANSS are among DUP predictors.
Longer DUP results from multiple patient- and illness-related factors. This has many implications in targeting early intervention with specific consideration to cultural factors.
未治疗精神病持续时间(DUP)被认为是精神病性障碍的一个不良预后因素。西方国家有多项研究在探究DUP的不同预测因素,而在埃及仅有少数研究考察了DUP的各种预测因素。
研究埃及精神病性障碍患者的DUP,并调查某些疾病、患者、社会文化风险因素及求助行为与DUP延长之间的关联。
选取100例符合《精神疾病诊断与统计手册》(第4版,修订版;DSM-IV-TR)精神病性障碍诊断标准的患者进行访谈以评估DUP。使用DSM-IV轴I障碍结构化临床访谈(SCID-I)、阳性和阴性症状量表(PANSS)及总体功能评定量表(GAF)对他们进行访谈。
发现DUP的平均(±标准差(SD))为36.93(±45.27)个月。DUP与各种社会人口学和临床变量相关。对DUP进行对数转换后,与PANSS评分进行相关性分析,结果显示DUP与PANSS阴性及阳性评分之间存在高度显著的统计学关系。线性回归分析发现,患者年龄、起病年龄、居住地、文盲状态、隐匿起病方式、精神病性障碍阴性家族史以及PANSS所表明的疾病严重程度均为DUP的预测因素。
较长的DUP源于多种与患者及疾病相关的因素。这对于考虑文化因素针对性地进行早期干预具有诸多启示。