Pelizza Lorenzo, Garlassi Sara, Azzali Silvia, Paterlini Federica, Scazza Ilaria, Chiri Luigi Rocco, Poletti Michele, Pupo Simona, Raballo Andrea
Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy.
Nord J Psychiatry. 2020 Aug;74(6):381-389. doi: 10.1080/08039488.2020.1733661. Epub 2020 Feb 28.
Previous research observed deficits in pleasure experience in chronic schizophrenia, but little is known about anhedonia in early psychosis. Aim of this study is: (1) to examine anhedonia in distinct help-seeking subgroups of young people identified through the First Episode Psychosis (FEP) criteria, (2) to investigate its correlations with psychopathology in the FEP sample, and (3) to monitor longitudinally its stability in the FEP group along 1-year follow-up period. All participants (137 FEP and 95 nonpsychotic psychiatric controls [i.e. non-FEP]), aged 13-35 years, completed the Comprehensive Assessment of At-Risk Mental States (CAARMS), the Schizotypal Personality Questionnaire - Brief version (SPQ-B), the Brief O-LIFE questionnaire (BOL), and the World Health Organization Quality of Life - Brief version (WHOQOL-BREF). We used two different indexes of anhedonia: CAARMS 'Anhedonia' item 4.3 and BOL 'Introvertive Anhedonia' subscale scores. In comparison with non-FEP, FEP patients showed higher baseline anhedonia scores. After 1-year follow-up period, FEP individuals had a significant decrease in severity of anhedonia scores. In the FEP group, anhedonia showed significant, enduring (over time) correlations with impaired role functioning, negative symptoms, comorbid depression, poorer self-perceived quality of life and specific schizotypal personality traits (i.e. interpersonal deficits). Anhedonia is relevant in the early phase of psychosis and its severity is associated with functioning deterioration and a bad quality of life.
以往研究观察到慢性精神分裂症患者存在愉悦体验缺陷，但对于早期精神病性障碍中的快感缺失却知之甚少。本研究的目的是：（1）在通过首发精神病（FEP）标准确定的不同求助亚组的年轻人中检查快感缺失情况；（2）在FEP样本中调查其与精神病理学的相关性；（3）在1年的随访期内纵向监测FEP组中其稳定性。所有年龄在13 - 35岁的参与者（137名FEP患者和95名非精神病性精神科对照者[即非FEP]）完成了高危精神状态综合评估（CAARMS）、分裂型人格问卷简版（SPQ - B）、简易O-LIFE问卷（BOL）以及世界卫生组织生活质量简版（WHOQOL - BREF）。我们使用了两种不同的快感缺失指标：CAARMS的“快感缺失”项目4.3和BOL的“内向性快感缺失”子量表得分。与非FEP相比，FEP患者的基线快感缺失得分更高。经过1年的随访期后，FEP个体的快感缺失得分严重程度显著降低。在FEP组中，快感缺失与角色功能受损、阴性症状、共病抑郁、较差的自我感知生活质量以及特定的分裂型人格特质（即人际缺陷）存在显著且持久（随时间推移）的相关性。快感缺失在精神病早期阶段具有相关性，其严重程度与功能恶化和生活质量差相关。
