Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
Schizophr Res. 2017 Dec;190:90-95. doi: 10.1016/j.schres.2017.03.043. Epub 2017 Mar 31.
Several studies have demonstrated that youth at clinical high risk (CHR) of developing psychosis have a high prevalence of comorbid psychiatric disorders. Less is known about the impact of comorbid diagnoses on later conversion to psychosis and the change over time. The aim of this study was to determine the frequency and distribution of psychiatric diagnoses at baseline and over time in the North American Prodrome Longitudinal Study (NAPLS 2) and the role of comorbid diagnoses in conversion to psychosis. The NAPLS 2 sample consisted of 744 CHR youth and 276 healthy controls. Only 21% of the CHR group did not have a comorbid diagnosis with many have 2-3 DSM-IV comorbid diagnoses. The most common diagnoses were anxiety and depressive disorders, which did improve over time. The only diagnosis at baseline that differentiated the converters from the non-converters was cannabis misuse. Comorbidity, except for cannabis use, was essentially independent of clinical outcome. It is possible that those with comorbid diagnoses are preferentially the help-seeking individuals that present for help in our clinics and research projects and that those who are at risk but do not have a comorbid diagnosis may not be seeking help in the prodromal phase.
多项研究表明，有临床发展为精神病高风险（CHR）的年轻人患有多种合并精神疾病的发病率很高。关于合并诊断对后来转为精神病的影响以及随时间变化的情况知之甚少。本研究的目的是确定北美前驱纵向研究（NAPLS 2）中基线时和随时间变化的精神疾病诊断的频率和分布，以及合并诊断在转为精神病中的作用。NAPLS 2 样本包括 744 名 CHR 年轻人和 276 名健康对照。只有 21%的 CHR 组没有合并诊断，许多人有 2-3 种 DSM-IV 合并诊断。最常见的诊断是焦虑和抑郁障碍，这些障碍随着时间的推移有所改善。基线时唯一能区分转化者和非转化者的诊断是大麻滥用。除大麻使用外，合并症基本上与临床结果无关。可能是那些有合并症诊断的人更倾向于在我们的诊所和研究项目中寻求帮助，而那些有风险但没有合并症诊断的人可能不会在前驱期寻求帮助。
