Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Early Interv Psychiatry. 2019 Dec;13(6):1416-1423. doi: 10.1111/eip.12786. Epub 2019 Jan 22.
The first aim of this project was to identify a sample of youth who met different stages of risk for the development of a serious mental illness (SMI) based on a published clinical staging model. The second aim was to determine whether participants allocated to the different stages were a good fit to the model by comparing these groups on a range of clinical measures.
This two-site longitudinal study recruited 243 youth, ages 12 to 25. The sample included (a) 42 healthy controls, (b) 43 non-help seeking individuals with no mental illness but with some risk of SMI, such as having a first-degree relative with a SMI (stage 0), (c) 52 help-seeking youth experiencing distress and possibly mild symptoms of anxiety or depression (stage 1a) and (d) 108 youth with attenuated symptoms of SMI, such as bipolar disorder or psychosis (stage 1b). Participants completed a range of measures assessing depression, anxiety, mania, suicide ideation, attenuated psychotic symptoms, negative symptoms, anhedonia and beliefs about oneself.
There were no clinical differences between HCs and participants in stage 0. For most of the clinical measures, participants in stage 1b had more severe ratings than participants in stages 1a and 0 and HCs; those in stage 1a had more severe ratings than HCs and stage 0 participants.
These results suggest that the staging process used to allocate participants to various stages is a good fit. That is, the clinical ratings followed an ordering effect consistent with that hypothesized in the staging model.
本项目的首要目的是基于已发表的临床分期模型，确定一组符合不同严重精神障碍（SMI）发病风险阶段的青年人群样本。其次目的是通过比较不同分期组在一系列临床指标上的差异，确定将参与者分配到不同分期是否符合该模型。
本两站点纵向研究招募了 243 名年龄在 12 至 25 岁的青年。样本包括：（a）42 名健康对照者，（b）43 名无精神疾病但有 SMI 风险的非求助者，如一级亲属有 SMI（阶段 0），（c）52 名有困扰且可能有轻度焦虑或抑郁症状的求助者（阶段 1a），以及（d）108 名有 SMI 症状减轻的青年，如双相情感障碍或精神病（阶段 1b）。参与者完成了一系列评估抑郁、焦虑、躁狂、自杀意念、精神病症状减轻、阴性症状、快感缺失和自我信念的量表。
健康对照者与阶段 0 参与者之间没有临床差异。对于大多数临床指标，阶段 1b 参与者的评分比阶段 1a 和阶段 0 参与者更严重，而阶段 1a 参与者的评分比健康对照者和阶段 0 参与者更严重。
这些结果表明，用于将参与者分配到不同阶段的分期过程是合理的。也就是说，临床评分遵循与分期模型假设一致的有序效应。
