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认知和社会功能作为有精神病性症状减弱的青少年向精神病转变的预测因素的作用。

The Role of Cognition and Social Functioning as Predictors in the Transition to Psychosis for Youth With Attenuated Psychotic Symptoms.

作者信息

Addington Jean, Liu Lu, Perkins Diana O, Carrion Ricardo E, Keefe Richard S E, Woods Scott W

机构信息

Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, AB, Canada;

Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, AB, Canada.

出版信息

Schizophr Bull. 2017 Jan;43(1):57-63. doi: 10.1093/schbul/sbw152. Epub 2016 Oct 25.

Abstract

In the literature, there have been several attempts to develop prediction models for youth who are at clinical high risk (CHR) of developing psychosis. Although there are no specific clinical or demographic variables that seem to consistently predict the later transition to psychosis in those CHR youth, in addition to attenuated psychotic symptoms, the most commonly occuring predictors tend to be poor social functioning and certain cognitive tasks. Unfortunately, there has been little attempt to replicate alogorithms. A recently published article by Cornblatt et al suggested that, for individuals with attentuated psychotic symptoms (APS), disorganized communication, suspiciousness, verbal memory, and a decline in social functioning were the best predictors of later transition to psychosis (the RAP model). The purpose of this article was to first test the prediction model of Cornblatt et al with a new sample of individuals with APS from the PREDICT study. The RAP model was not the best fit for the PREDICT data. However, using other variables from PREDICT, it was demonstrated that unusual thought content, disorganized communication, baseline social functioning, verbal fluency, and memory, processing speed and age were predictors of later transition to psychosis in the PREDICT sample. Although the predictors were different in these 2 models, both supported that disorganized communication, poor social functioning, and verbal memory, were good candidates as predictors for later conversion to psychosis.

摘要

在文献中,已经有几次尝试为处于精神病临床高危(CHR)的青少年开发预测模型。尽管没有特定的临床或人口统计学变量似乎能始终如一地预测那些CHR青少年日后向精神病的转变,但除了精神病性症状减弱外,最常出现的预测因素往往是社会功能差和某些认知任务。不幸的是,几乎没有人尝试复制这些算法。Cornblatt等人最近发表的一篇文章表明,对于有精神病性症状减弱(APS)的个体,言语紊乱、猜疑、言语记忆和社会功能下降是日后向精神病转变的最佳预测因素(RAP模型)。本文的目的是首先用来自PREDICT研究的有APS个体的新样本检验Cornblatt等人的预测模型。RAP模型并不最适合PREDICT数据。然而,使用PREDICT中的其他变量,结果表明,异常思维内容、言语紊乱、基线社会功能、言语流畅性、记忆、处理速度和年龄是PREDICT样本中日后向精神病转变的预测因素。尽管这两个模型中的预测因素不同,但两者都支持言语紊乱、社会功能差和言语记忆是日后转变为精神病的良好预测候选因素。

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