Izquierdo Ana, Cabello María, de la Torre-Luque Alejandro, Ayesa-Arriola Rosa, Setien-Suero Esther, Mayoral-van-Son Jacqueline, Vazquez-Bourgon Javier, Ayuso-Mateos Jose Luis, Crespo-Facorro Benedicto
Department of Psychiatry, University Hospital La Princesa. Instituto de Investigación Sanitaria Princesa, IIS Princesa, Madrid, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, School of Medicine, Madrid, Spain.
CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
J Psychiatr Res. 2021 Apr;136:483-491. doi: 10.1016/j.jpsychires.2020.10.019. Epub 2020 Oct 22.
The domains of functioning affected by first episode of psychosis (FEP) could be analysed as forming a network of interacting or even reinforcing elements. The reasons why longer duration of untreated psychosis (DUP) might be related to higher disability are not still clear. The aim of the present study is to evaluate how different areas of functioning are inter-related according to the length of DUP in patients with FEP, with a particular focus on studying the relative influence of each other according to lengthy delays in initial treatment.
441 participants in an epidemiological and intervention program of first episode psychosis (PAFIP) were included in our study. Functioning problems at baseline were assessed with the WHO Disability Assessment Schedule (DAS). Three networks of functioning domains have been estimated according to the length of DUP.
All the DAS items took part in the different networks. We have not found differences across the edge weights in the short, medium and long DUP groups. The domains "social withdrawal", "participation in the household activities", "general interest and information", and "low level of activity" seem to act as bridge items with other areas of functioning in people with longer DUP.
Our results could have clinical implications for patients with longer DUP, in which case, social withdrawal, household activities, level of activity and general interest in the world around them, could be high-priority target areas of treatment, since they seem to be mediating the relation between others areas of functioning.
首次发作精神病（FEP）所影响的功能领域可被分析为形成一个相互作用甚至相互强化的要素网络。未治疗精神病持续时间（DUP）较长可能与更高残疾程度相关的原因仍不清楚。本研究的目的是评估FEP患者中不同功能领域如何根据DUP的长短相互关联，特别关注根据初始治疗的长时间延迟来研究彼此之间的相对影响。
我们的研究纳入了首次发作精神病流行病学和干预项目（PAFIP）中的441名参与者。使用世界卫生组织残疾评估量表（DAS）评估基线时的功能问题。根据DUP的长短估计了三个功能领域网络。
所有DAS项目都参与了不同的网络。我们未在短、中、长DUP组的边权重上发现差异。“社交退缩”“参与家务活动”“一般兴趣和信息”以及“低活动水平”等领域似乎在DUP较长的人群中充当与其他功能领域的桥梁项目。
我们的结果可能对DUP较长的患者具有临床意义，在这种情况下，社交退缩、家务活动、活动水平以及对周围世界的一般兴趣可能是治疗的高优先目标领域，因为它们似乎在介导其他功能领域之间的关系。
