Enderami Atena, Monesi Fatemeh Sheikh, Zarghami Mehran
Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran.
Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran.
Mater Sociomed. 2017 Mar;29(1):21-25. doi: 10.5455/msm.2017.29.21-25.
Early diagnosis of symptoms related to psychotic disorders causes hyper responsiveness, recurrence reduction and quality of life improvement. The aim of this study was one-year follow-up of the clinical course and outcomes of hospitalized patients with first episode psychotic disorders and detection of factors affecting consequences.
This longitudinal descriptive study was conducted during 2012 to 2013 on hospitalized patients at Zare Hospital in Sari, Iran, with any psychotic symptoms and with diagnosis of first episode psychosis. The severity of psychotic symptoms was assessed via PANSS scale (Positive and Negative Syndrome Scale) and the global functioning through Global Assessment of Functioning (GAF) scale on admission, discharge day, 6 and 12 months later. Data were analyzed using ANOVA and t-test in SPSS 20 software.
Thirty two patients had complete follow-up (25 men and 7 women) (mean age of 29.37 ± 8.02). Discharge diagnosis was as 8 (25%) bipolar disorder with psychotic features, 8 (25%) not otherwise specified (NOS), 7 (22%) schizophrenia forum disorder, 7 (22%) psychotic disorder caused by abuse materials, 2 (6%) major depressive disorder with psychotic features. There was drug abuse in half of the patients. The drug abuse in the patients had a positive relationship with the recurrence of psychotic symptoms (p=0.04).
A significant percentage of patients with first episode psychosis (50%) within 12 months after the primary hospitalization experienced recurrence of psychotic symptoms. Likewise, global functioning had no major improvement in the patients. It seems essential the necessity of comprehensive services after discharge, especially in patients with drug abuse, and further support of social service centers.
早期诊断与精神障碍相关的症状可引起高反应性、减少复发并改善生活质量。本研究的目的是对首次发作精神障碍的住院患者进行为期一年的临床病程及结局随访，并检测影响结局的因素。
本纵向描述性研究于2012年至2013年期间在伊朗萨里的扎雷医院对有任何精神症状且诊断为首次发作精神病的住院患者进行。通过阳性和阴性症状量表（PANSS）评估精神症状的严重程度，并通过功能总体评定量表（GAF）在入院时、出院日、6个月和12个月后评估总体功能。使用SPSS 20软件中的方差分析和t检验对数据进行分析。
32例患者完成随访（25例男性和7例女性）（平均年龄29.37±8.02）。出院诊断为8例（25%）伴有精神病性特征的双相情感障碍，8例（25%）未另行规定（NOS），7例（22%）精神分裂症谱系障碍，7例（22%）物质所致精神障碍，2例（6%）伴有精神病性特征的重度抑郁症。一半的患者存在药物滥用。患者中的药物滥用与精神症状复发呈正相关（p=0.04）。
首次发作精神病患者中有相当比例（50%）在首次住院后12个月内出现精神症状复发。同样，患者的总体功能没有显著改善。出院后提供综合服务似乎至关重要，尤其是对有药物滥用问题的患者，并且需要社会服务中心提供进一步支持。
