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转诊至超高风险诊所的原因能否预测向精神病的转变?

Does reason for referral to an ultra-high risk clinic predict transition to psychosis?

作者信息

Rice Simon, Polari Andrea, Thompson Andrew, Hartmann Jessica, McGorry Patrick, Nelson Barnaby

机构信息

Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.

Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.

出版信息

Early Interv Psychiatry. 2019 Apr;13(2):318-321. doi: 10.1111/eip.12679. Epub 2018 Jun 6.

Abstract

AIM

To examine reasons for referral to a specialist ultra-high risk (UHR) for psychosis clinic and whether these reasons are associated with risk for subsequent transition to psychosis.

METHODS

Data for 127 patients referred to the Personal Assessment and Crisis Evaluation clinic were collected by medical record audit. Time to transition to psychosis was calculated from date of referral to time at which the young person was judged by their treating team to be experiencing onset of first episode psychosis.

RESULTS

Patients were primarily referred due to attenuated psychotic symptoms and depression (40.2%). There was an association with transition, with those in the attenuated psychotic-symptom-only category being more likely to transition.

CONCLUSION

As well as attenuated psychotic symptoms, depression and anxiety were also important reasons for referral indicating that there is a broad clinical phenotype of young people presenting to UHR clinics. Clinical reason for referral may index level of risk for subsequent transition to psychosis.

摘要

目的

探讨转介至专门的超高风险精神病诊所的原因,以及这些原因是否与随后发展为精神病的风险相关。

方法

通过病历审核收集了127名转介至个人评估与危机评估诊所的患者的数据。从转介日期到治疗团队判定该年轻人首次发作精神病的时间计算出发展为精神病的时间。

结果

患者主要因精神病性症状减弱和抑郁而被转介(40.2%)。转介原因与发展为精神病存在关联,仅表现出精神病性症状减弱的患者更有可能发展为精神病。

结论

除了精神病性症状减弱外,抑郁和焦虑也是转介的重要原因,这表明就诊于超高风险诊所的年轻人具有广泛的临床表型。转介的临床原因可能预示着随后发展为精神病的风险水平。

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