Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands.
Department of Neuroscience, Centre for Contextual Psychiatry, KU Leuven - University of Leuven, Leuven, Belgium.
Acta Psychiatr Scand. 2017 Jul;136(1):63-73. doi: 10.1111/acps.12714. Epub 2017 Mar 5.
The aim of this study was to assess associations between momentary stress and both affective and psychotic symptoms in everyday life of individuals at clinical high risk (CHR), compared to chronic psychotic patients and healthy controls, in search for evidence of early stress sensitization. It also assessed whether psychotic experiences were experienced as stressful.
The experience sampling method was used to measure affective and psychotic reactivity to everyday stressful activities, events and social situations in 22 CHR patients, 24 patients with a psychotic disorder and 26 healthy controls.
Multilevel models showed significantly larger associations between negative affect (NA) and activity-related stress for CHR patients than for psychotic patients (P = 0.008) and for CHR compared to controls (P < 0.001). Similarly, the association between activity-related stress and psychotic symptoms was larger in CHR than in patients (P = 0.02). Finally, the association between NA and symptoms (P < 0.001) was larger in CHR than in patients.
Stress sensitization seems to play a role particularly in the early phase of psychosis development as results suggest that CHR patients are more sensitive to daily life stressors than psychotic patients. In this early phase, psychotic experiences also contributed to the experience of stress.
本研究旨在评估个体处于临床高风险（CHR）状态下，与慢性精神病患者和健康对照组相比，日常生活中的瞬间压力与情感和精神病症状之间的关联，以寻找早期应激敏感的证据。它还评估了精神病体验是否被视为压力。
采用经验抽样法，对 22 名 CHR 患者、24 名精神病患者和 26 名健康对照者进行日常应激活动、事件和社会情境对情感和精神病反应的测量。
多层次模型显示，与精神病患者相比，CHR 患者的负性情绪（NA）与活动相关应激之间的关联更大（P = 0.008），与 CHR 患者相比，与健康对照组的关联更大（P < 0.001）。同样，活动相关应激与精神病症状之间的关联在 CHR 中比在患者中更大（P = 0.02）。最后，NA 与症状之间的关联（P < 0.001）在 CHR 中比在患者中更大。
应激敏感似乎在精神病发展的早期阶段发挥作用，因为结果表明 CHR 患者比精神病患者对日常生活应激源更敏感。在这个早期阶段，精神病体验也导致了压力的体验。
