Althwanay Aldanah, AlZamil Nada A, Almukhadhib Omar Y, Alkhunaizi Shahd, Althwanay Reem
Internal Medicine, Imam Abdulrahman Bin Faisal University, Khobar, SAU.
Psychiatry, Imam Abdulrahman Bin Faisal University, Dammam, SAU.
Cureus. 2020 Jun 15;12(6):e8639. doi: 10.7759/cureus.8639.
Psychosis is a syndrome characterized by features of reality distortion such as delusions and hallucinations. It may occur as a primary mental disorder or secondary to a medical or neurological illness or substance abuse. Several genetic, environmental, and protective risk factors have been identified and require further study. Neurobiological damage at the onset of schizophrenia is the most active and destructive. Therefore, it is important to detect the prodromal phase of psychosis so that interventions can be started early and the onset of psychosis delayed. Herein, we review the relevant epidemiological data on psychosis, particularly in Saudi Arabia. In addition, the risk and protective factors of psychosis will be discussed. Recent findings have shown that psychosis development is affected by genetic and environmental factors. Psychotic disorders are considered a cause of disability and are, therefore, a substantial economic burden. Consequently, it is important to try and detect the psychosis in its prodromal stage, where intervention may slow its progression and improve general wellbeing. Several tools have been identified to screen for the prodrome of psychosis, one of which is the prodromal questionnaire-brief version. This has been shown to be a promising tool that can be self-administered by the patient in contrast to long interview-based tools, which are time-consuming and require a physician to perform. Despite the limited evidence in the literature, there have been significant improvements in the outcomes of patients with psychosis when treated in the prodromal period. In summary, this article provides psychiatrists and researchers with an overview of psychosis, its risk factors, the prodromal stage of psychosis, tools to detect the prodromal phase, and potential treatments during this phase.
精神病是一种以现实扭曲特征为特点的综合征，如妄想和幻觉。它可能作为原发性精神障碍出现，也可能继发于医学或神经系统疾病或药物滥用。已经确定了几种遗传、环境和保护性风险因素，需要进一步研究。精神分裂症发病时的神经生物学损伤最为活跃且具有破坏性。因此，检测精神病的前驱期很重要，以便能尽早开始干预并延缓精神病的发作。在此，我们回顾关于精神病的相关流行病学数据，尤其是沙特阿拉伯的情况。此外，还将讨论精神病的风险和保护因素。最近的研究结果表明，精神病的发展受遗传和环境因素影响。精神障碍被认为是致残原因，因此是一项巨大的经济负担。所以，尝试在精神病的前驱期检测到它很重要，在此阶段进行干预可能会减缓其进展并改善总体健康状况。已经确定了几种筛查精神病前驱期的工具，其中之一是《前驱期问卷简版》。与基于长时间访谈的工具相比，它已被证明是一种很有前景的工具，患者可以自行填写，而基于长时间访谈的工具既耗时又需要医生来操作。尽管文献中的证据有限，但在前驱期接受治疗的精神病患者的治疗效果已有显著改善。总之，本文为精神科医生和研究人员提供了关于精神病、其风险因素、精神病前驱期、检测前驱期的工具以及此阶段潜在治疗方法的概述。
