Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.
Department of Psychology and Logopedics, Faculty of Medicine, Helsinki University, Helsinki, Finland.
Eur Psychiatry. 2019 Jan;55:102-108. doi: 10.1016/j.eurpsy.2018.10.004. Epub 2018 Nov 15.
We investigated whether psychosis risk symptoms predicted psychiatric service use using seven-year register follow-up data.
Our sample included 715 adolescents aged 15-18, referred to psychiatric care for the first time. Psychosis risk symptoms were assessed with the Prodromal Questionnaire (PQ) at the beginning of the treatment. We assessed the power of the overall PQ as well as its positive, negative, general, and disorganized psychosis risk symptom factors in predicting prolonged service use. Baseline psychiatric diagnoses (grouped into 7 categories) were controlled for. Based on both inpatient and outpatient psychiatric treatment after baseline, adolescents were divided into three groups of brief, intermittent, and persistent service use.
Stronger symptoms on any PQ factor as well as the presence of a mood disorder predicted prolonged service use. All of the PQ factors remained significant predictors when adjusted for baseline mood disorder and multimorbidity.
In a prospective follow-up of a large sample using comprehensive mental health records, our findings indicate that assessing psychosis risk symptoms in clinical adolescent settings at the beginning of treatment could predict long-term need for care beyond diagnostic information. Our findings replicate the previous findings that positive psychosis risk symptoms are unspecific markers of severity of psychopathology. Also psychosis risk symptoms of the negative, disorganization, and general clusters are approximately as strongly associated with prolonged psychiatric service use in the upcoming years.
我们通过七年的登记随访数据，调查了精神病风险症状是否可以预测精神卫生服务的使用。
我们的样本包括 715 名 15-18 岁首次接受精神科治疗的青少年。在治疗开始时使用前驱症状问卷（PQ）评估精神病风险症状。我们评估了总体 PQ 以及其阳性、阴性、一般和紊乱性精神病风险症状因素在预测长期服务使用中的作用。控制了基线时的精神科诊断（分为 7 类）。根据基线后的住院和门诊精神科治疗，青少年被分为短暂、间歇性和持续服务使用三组。
任何 PQ 因子上的症状更严重以及存在心境障碍预测了长期服务使用。当调整基线时的心境障碍和多种合并症后，所有 PQ 因子仍然是显著的预测因子。
在对使用全面心理健康记录的大样本进行的前瞻性随访中，我们的研究结果表明，在治疗开始时评估临床青少年环境中的精神病风险症状，可以预测超出诊断信息的长期护理需求。我们的研究结果复制了之前的发现，即阳性精神病风险症状是精神病理学严重程度的非特异性标志物。此外，在未来几年，阴性、紊乱和一般集群的精神病风险症状与延长精神卫生服务使用的相关性大致相同。
