Programma2000 - Center for Early Detection and Intervention in Psychosis, Department of Mental Health, ASST Niguarda Hospital, Milan, Italy.
Programma2000 - Center for Early Detection and Intervention in Psychosis, Department of Mental Health, ASST Niguarda Hospital, Milan, Italy.
Psychiatry Res. 2020 Sep;291:113200. doi: 10.1016/j.psychres.2020.113200. Epub 2020 Jun 7.
Treatment in early intervention services (EIS) seems superior to treatment as usual on several outcomes, but the extent of heterogeneity in response is unclear. In this study, treatment response trajectories up to 2 years in first-episode psychosis (FEP) patients enrolled in an Italian early intervention service (EIS) have been quantified. The 24-item Brief Psychiatric Rating Scale (BPRS) was used to quantify treatment response up to 2 years in 129 participants. Conditional growth modeling and latent class growth analysis were used to test changes over time in the BPRS and separation into independent classes over time. Group differences were tested on socio-demographic and clinical variables known to be related to outcome in psychosis. Scores on the BPRS showed a statistically significant decrease in overall scores across all tested models. Four trajectories were identified across 2 years. Most patients showed a progressive decrease in the BPRS scores; a scant fraction showed a more stepped decrease from very high levels of psychopathology. No potential predictor was statistically related to the time course of BPRS scores. Most patients that undergo treatment within an EIS are characterized by amelioration, but patients that have higher baseline scores of psychopathology require more intensive treatment.
早期干预服务(EIS)中的治疗在多个结果上似乎优于常规治疗,但反应的异质性程度尚不清楚。在这项研究中,对意大利早期干预服务(EIS)中首次出现精神病(FEP)患者的治疗反应轨迹进行了长达 2 年的量化。使用 24 项简明精神病评定量表(BPRS)来量化 129 名参与者在 2 年内的治疗反应。条件增长模型和潜在类别增长分析用于测试 BPRS 随时间的变化,并随时间分离为独立类别。在精神病的结果相关的已知社会人口统计学和临床变量上测试组间差异。BPRS 的得分在所有测试模型中均显示出总体得分呈统计学显著下降。在 2 年内确定了 4 种轨迹。大多数患者的 BPRS 评分呈逐渐下降趋势;少数患者从较高水平的精神病理学表现出更为渐进的下降。没有潜在的预测因素与 BPRS 评分的时间过程有统计学关系。在 EIS 中接受治疗的大多数患者的病情有所改善,但基线精神病理学评分较高的患者需要更强化的治疗。