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抗精神病药对首发精神病患者反刍思维的影响。

Effects of antipsychotics on rumination in patients with first-episode psychosis.

机构信息

Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea.

Department of psychiatry, Maeumsarang Hospital, Wanju, Jeollabuk-do, Republic of Korea.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2020 Dec 20;103:109983. doi: 10.1016/j.pnpbp.2020.109983. Epub 2020 May 25.

Abstract

BACKGROUND

Rumination is a well-known risk factor for depression. It is also associated with negative and positive symptoms and suicidality in patients suffering from psychosis. However, no studies have addressed the effect of antipsychotics on rumination.

METHODS

Using the Brooding Scale (BS), we investigated the effect of antipsychotics on rumination at the 6-month follow up in patients with first-episode psychosis (n = 257). The relationship between rumination and other clinical variables was explored by conducting a correlation analysis and structural equation modeling (SEM). The clinical characteristics and short-term outcomes were compared between high and low ruminators at 6 months.

RESULTS

Significant reductions in rumination and various clinical variables were observed at the 6-month follow-up. A significant correlation was observed between rumination and the score on the positive subscale of the Positive and Negative Syndrome Scale (PANSS). A direct path between the PANSS score and rumination was identified by SEM. High ruminators had more severe psychopathology, experienced more childhood traumas, and took less exercise than low ruminators. The recovery rate at 6 months was higher in low ruminators than in high ruminators.

CONCLUSIONS

Our findings suggest that antipsychotics are beneficial for reducing rumination in patients with first-episode psychosis. The outcomes at the 6-month follow-up were better in low ruminators than high ruminators.

摘要

背景

反刍是抑郁的一个众所周知的风险因素。它也与精神病患者的负面和正面症状以及自杀倾向有关。然而,目前还没有研究探讨抗精神病药物对反刍的影响。

方法

我们使用沉思量表(BS),在首发精神病患者(n=257)的 6 个月随访中,研究了抗精神病药物对反刍的影响。通过进行相关分析和结构方程建模(SEM),探讨了反刍与其他临床变量之间的关系。比较了 6 个月时高反刍者和低反刍者的临床特征和短期结局。

结果

在 6 个月的随访中,反刍和各种临床变量都有显著下降。反刍与阳性症状量表(PANSS)的阳性分量表得分之间存在显著相关性。通过 SEM 确定了 PANSS 评分与反刍之间的直接路径。高反刍者的精神病理学更严重,童年创伤经历更多,运动更少,而低反刍者则更少。低反刍者在 6 个月时的恢复率高于高反刍者。

结论

我们的研究结果表明,抗精神病药物有助于降低首发精神病患者的反刍。低反刍者的 6 个月随访结果优于高反刍者。

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