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精神病临床高危中国大学生的共病精神障碍及6个月症状和功能转归

Comorbid Mental Disorders and 6-Month Symptomatic and Functioning Outcomes in Chinese University Students at Clinical High Risk for Psychosis.

作者信息

Shi Jingyu, Wang Lu, Yao Yuhong, Su Na, Zhan Chenyu, Mao Ziyu, Zhao Xudong

机构信息

East Hospital, Tongji University School of Medicine, Shanghai, China.

Tongji University School of Medicine, Shanghai, China.

出版信息

Front Psychiatry. 2017 Oct 23;8:209. doi: 10.3389/fpsyt.2017.00209. eCollection 2017.

Abstract

BACKGROUND

High rates of non-psychotic psychopathological symptoms have been observed in clinical population at clinical high risk (CHR) for psychosis. These comorbid disorders affected the baseline functional level of CHR patients. However, little is known about the comorbid mental disorder in CHR individuals in non-clinical adolescent population. This study aimed to investigate the comorbid mental disorder in non-clinical CHR adolescents and the impact on attenuated psychosis symptoms (APS) as well as clinical outcome.

METHODS

The sample consisted of 32 CHR students, who were screened from 2,800 university students. CHR status was evaluated with the Structured Interview of Prodromal Syndromes, comorbid mental disorder diagnoses with the International Neuropsychiatric Interview.

RESULTS

In the CHR sample, 46.9% was found at least one non-psychotic comorbid mental disorder. The CHR participants presenting comorbid mental disorder had significantly more severity of APS than those without comorbid mental disorders, and the remission rate at 6-month follow-up is significantly higher in the individuals without comorbid mental disorders at baseline.

CONCLUSION

In the non-clinical sample of individuals at CHR, non-psychotic comorbid mental disorders are common and anxiety disorder is most frequent. Copresence of anxiety and/or depression is related to higher level of attenuated psychotic symptoms and unfavorable clinical outcome at 6-month follow-up. Assessment and intervention in anxiety and depression for non-clinical CHR adolescents are suggested.

摘要

背景

在临床高危(CHR)精神病患者的临床人群中观察到非精神病性精神病理症状的高发生率。这些共病障碍影响了CHR患者的基线功能水平。然而,对于非临床青少年人群中CHR个体的共病精神障碍知之甚少。本研究旨在调查非临床CHR青少年中的共病精神障碍及其对精神病性症状衰减(APS)以及临床结局的影响。

方法

样本包括从2800名大学生中筛选出的32名CHR学生。使用前驱症状结构化访谈评估CHR状态,使用国际神经精神病学访谈进行共病精神障碍诊断。

结果

在CHR样本中,发现46.9%至少有一种非精神病性共病精神障碍。存在共病精神障碍的CHR参与者的APS严重程度显著高于无共病精神障碍者,且基线时无共病精神障碍个体在6个月随访时的缓解率显著更高。

结论

在CHR个体的非临床样本中,非精神病性共病精神障碍很常见,焦虑症最为频繁。焦虑和/或抑郁的共存与6个月随访时更高水平的精神病性症状衰减及不良临床结局相关。建议对非临床CHR青少年的焦虑和抑郁进行评估和干预。

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