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年龄对精神病症状超高风险患病率的影响:在精神病早期检测服务的临床样本中的重复研究。

Age effect on prevalence of ultra-high risk for psychosis symptoms: replication in a clinical sample of an early detection of psychosis service.

作者信息

Schultze-Lutter Frauke, Hubl Daniela, Schimmelmann Benno G, Michel Chantal

机构信息

University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern, Switzerland.

Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Bergische Landstraße 2, 40629, Düsseldorf, Germany.

出版信息

Eur Child Adolesc Psychiatry. 2017 Nov;26(11):1401-1405. doi: 10.1007/s00787-017-0994-y. Epub 2017 Apr 29.

Abstract

Higher frequencies of perceptual and lesser clinical significance of non-perceptual attenuated psychotic symptoms (APS) have been reported by 8- to 15-year-old of the general population compared to 16- to 40-year-old. We examined if such an age-effect can also be detected in a clinical never-psychotic sample (N = 133) referred to a specialized service for clinical suspicion of developing psychosis. APS and brief intermittent psychotic symptoms (BIPS) were assessed using items P1-P3 and P5 (non-perceptual), and P4 (perceptual) of the Structured Interview for Psychosis-Risk Syndromes, current axis-I disorders with the Mini-International Neuropsychiatric Interview, and psychosocial functioning with the Social and Occupational Functioning Assessment Scale. In the sample, 64% reported APS (61%) or BIPS (7%); any perceptual APS/BIPS was reported by 43% and any non-perceptual APS/BIPS by 44%. In correspondence to the results in the general population sample, perceptual but not non-perceptual APS/BIPS were significantly more frequent in younger age groups below the age of 16 (8-12 years: odds ratio (OR) = 4.7 (1.1-19.5); 13-15 years: OR = 2.7 (0.9-7.7); 20-24-year-old as reference group). An age-effect of APS/BIPS on the presence of any current axis-I disorder (59%) or functional difficulties (67%) was not detected. However, when onset requirements of APS criteria (onset/worsening in past year) were met, the likelihood of a psychiatric diagnosis increased significantly with advancing age. Overall, the replicated age-effect on perceptual APS/BIPS in this clinical sample highlights the need to examine ways to distinguish clinically relevant perceptual APS/BIPS from perceptual aberrations likely remitting over the course of adolescence.

摘要

与16至40岁人群相比,普通人群中8至15岁的个体报告的感知性非感知性减弱的精神病性症状(APS)频率更高,临床意义更小。我们研究了在因临床怀疑有精神病发作而被转介到专门服务机构的临床从未患过精神病的样本(N = 133)中是否也能检测到这种年龄效应。使用精神病风险综合征结构化访谈的P1 - P3和P5项(非感知性)、P4项(感知性)、用迷你国际神经精神病学访谈评估当前的轴I障碍,并用社会和职业功能评估量表评估社会心理功能,对APS和短暂间歇性精神病性症状(BIPS)进行评估。在该样本中,64%的人报告有APS(61%)或BIPS(7%);43%的人报告有任何感知性APS/BIPS,44%的人报告有任何非感知性APS/BIPS。与普通人群样本的结果一致,16岁以下的较年轻年龄组中,感知性而非非感知性APS/BIPS明显更常见(8 - 12岁:优势比(OR)= 4.7(1.1 - 19.5);13 - 15岁:OR = 2.7(0.9 - 7.7);以20 - 24岁作为参照组)。未检测到APS/BIPS对任何当前轴I障碍(59%)或功能困难(67%)存在情况的年龄效应。然而,当满足APS标准的起病要求(过去一年起病/加重)时,随着年龄增长,精神病诊断的可能性显著增加。总体而言,该临床样本中对感知性APS/BIPS重复出现的年龄效应凸显了有必要研究如何将临床上相关的感知性APS/BIPS与可能在青春期过程中缓解的感知异常区分开来。

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