Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
Department of Psychiatry, University of California San Diego, La Jolla, California.
Early Interv Psychiatry. 2019 Apr;13(2):251-256. doi: 10.1111/eip.12471. Epub 2017 Aug 9.
On average, there is a 10% to 12% likelihood of developing a psychotic disorder solely based on being at familial high risk. However, the introduction of the criteria for clinical high risk (CHR) of psychosis suggested for CHR individuals, 20% to 30% will go on to develop a full-blown psychotic illness within 3 years. Several studies suggest a role for family history in conversion to psychosis among those at CHR. However, we know very little about those who meet the CHR criteria and have a positive family history for psychosis compared to those at CHR with no known family history. The aim of this study was to compare these 2 groups on demographics, clinical symptoms, social and role functioning, IQ, environmental factors and conversion to psychosis.
A total of 762 participants met criteria for being at CHR, 119 of whom had a family history (CHR + FH) and 643 without (CHR-FH). Groups were compared on attenuated symptoms, role and social functioning, IQ, past trauma, perceived discrimination and cannabis use. Survival analysis was used to compare groups on conversion rates.
There were no major differences between the groups in symptoms, functioning, IQ, cannabis use or in the rate of conversion between the groups. The CHR + FH group reported increased amounts of early trauma.
There is a possibility that CHR + FH individuals believe that it is more difficult for them to cope with circumstances such as abuse or potential abuse. Future research on this subject should investigate family environment and its role in conversion to psychosis among CHR + FH individuals.
仅基于家族高风险，发展精神病的可能性平均为 10%至 12%。然而，对于精神病临床高风险（CHR）的标准的引入表明，20%至 30%的 CHR 个体将在 3 年内发展为全面的精神病。几项研究表明，家族史在 CHR 个体向精神病转化中起作用。然而，我们对符合 CHR 标准且有精神病家族史的人与没有已知家族史的 CHR 患者知之甚少。本研究的目的是比较这两组在人口统计学、临床症状、社会和角色功能、智商、环境因素以及向精神病的转化方面的差异。
共有 762 名参与者符合 CHR 标准，其中 119 名有家族史（CHR+FH），643 名没有（CHR-FH）。比较了两组在减弱症状、角色和社会功能、智商、过去创伤、感知歧视和大麻使用方面的差异。采用生存分析比较了两组的转化率。
两组在症状、功能、智商、大麻使用或两组之间的转化率方面没有显著差异。CHR+FH 组报告了更多的早期创伤。
CHR+FH 个体可能认为自己更难以应对虐待或潜在虐待等情况。未来关于这个主题的研究应该调查家庭环境及其在 CHR+FH 个体向精神病转化中的作用。
