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物质所致精神病性障碍的年轻人的特征和结局。

Characteristics and outcomes of young people with substance induced psychotic disorder.

机构信息

Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia; Orygen Youth Health, 35 Poplar Rd, Parkville, VIC 3025, Australia.

Orygen Youth Health, 35 Poplar Rd, Parkville, VIC 3025, Australia.

出版信息

Schizophr Res. 2019 Apr;206:257-262. doi: 10.1016/j.schres.2018.11.007. Epub 2018 Nov 22.

Abstract

BACKGROUND

Substance induced psychotic disorders (SIPD) have been historically considered as associated with better clinical and functional outcomes than other psychotic diagnoses. As a result, treatments for those with SIPD are often considerably less intensive, yet this is not based on evidence. The present study aimed to examine whether differences exist between those with SIPD and other first episode psychosis (FEP) diagnoses in regards to demographic and clinical factors, and to determine the symptomatic, clinical and functional outcomes in those with SIPD.

METHODS

This study included all young people aged 15-24 who presented with a FEP to the Early Psychosis Prevention and Intervention Centre between 01/01/2011 and 31/12/2013. Group differences were analysed with independent samples t-tests and chi-square analyses and equivalent non-parametric tests as appropriate. Where applicable, odds ratios were calculated.

RESULTS

544 young people presented with a FEP and 10.3% (N = 56) were diagnosed with SIPD. Individuals with SIPD were more likely to be male, unemployed, and have a comorbid substance use disorder. There were no significant differences between groups regarding duration of untreated psychosis, severity of psychotic symptoms, time to remission, or rates of relapse. Those with SIPD were less likely to be employed or engaged in study at discharge and 35.7% of those with SIPD had a change of diagnosis to a schizophrenia spectrum or bipolar disorder after a median of 84 weeks.

CONCLUSION

Young people diagnosed with SIPD should be an important focus of early intervention services and receive comparable treatment to those with other psychotic diagnoses.

摘要

背景

物质所致精神障碍(SIPD)在历史上被认为与其他精神障碍诊断相比具有更好的临床和功能结局。因此,SIPD 患者的治疗往往不那么密集,但这并非基于证据。本研究旨在检查 SIPD 患者与其他首发精神病(FEP)诊断在人口统计学和临床因素方面是否存在差异,并确定 SIPD 患者的症状、临床和功能结局。

方法

本研究纳入了 2011 年 1 月 1 日至 2013 年 12 月 31 日期间在早期精神病预防和干预中心就诊的所有年龄在 15-24 岁之间的首发精神病患者。采用独立样本 t 检验、卡方检验和适当的等效非参数检验分析组间差异。在适用的情况下,计算了优势比。

结果

544 名年轻人出现首发精神病,10.3%(N=56)被诊断为 SIPD。SIPD 患者更可能是男性、失业,并且存在合并物质使用障碍。两组在未治疗精神病持续时间、精神病症状严重程度、缓解时间或复发率方面无显著差异。SIPD 患者在出院时更不可能就业或继续学业,并且在中位数为 84 周后,有 35.7%的 SIPD 患者的诊断更改为精神分裂症谱系或双相障碍。

结论

应将诊断为 SIPD 的年轻人作为早期干预服务的重要重点,并给予与其他精神病诊断相当的治疗。

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