青年精神病风险人群的阴性症状与功能：系统评价与荟萃分析。
Negative Symptoms and Functioning in Youth at Risk of Psychosis: A Systematic Review and Meta-analysis.
机构信息
From the Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary.
出版信息
Harv Rev Psychiatry. 2020 Nov/Dec;28(6):341-355. doi: 10.1097/HRP.0000000000000273.
LEARNING OBJECTIVE
After participating in this activity, learners should be better able to:• Evaluate the relationship between negative symptoms and functioning in youth at clinical high risk for psychosis.
AIM
Youth at CHR for psychosis often demonstrate significant negative symptoms and poor functioning, though the magnitude and direction of the relationship between the two remains unknown. The objective of this systematic review is to summarize the relationship between negative symptoms and functioning in CHR samples.
METHOD
Electronic databases CINAHL, EBM, Embase, MEDLINE, and PsycINFO were searched from inception. Studies were selected if they included any study that reported a relationship between negative symptoms and functioning in youth at clinical high risk (CHR). The correlation coefficient r was converted to Cohen's d, and all random-effects meta-analyses were performed using the transformed values.
RESULTS
Forty-one studies met the inclusion criteria, including a total of 4574 individuals at CHR for psychosis. Negative symptom total scores were significantly associated with poorer global functioning (d, -1.40; 95% CI, -1.82 to -0.98; I = 79.4%; p < .001 [9 studies, n = 782]), social functioning (d, -1.10; 95% CI, -1.27 to -0.93; I = 10.40%; p < .001 [12 studies, n = 811]), and role functioning (d, -0.96; 95% CI, -1.17 to -0.76; I = 41.1%; p < .001 [9 studies, n = 881]). In addition, negative symptoms were consistently associated with poor premorbid functioning. When examining negative symptom domains, avolition, anhedonia, and blunted affect were each significantly and independently associated with poorer social functioning and role functioning. In terms of prediction models, negative symptoms contributed to the prediction of lower functioning across multiple studies.
CONCLUSION
This meta-analysis demonstrates a strong relationship between negative symptoms and functioning in youth at clinical high risk for psychosis.
学习目标
在参与此活动后，学习者应能够更好地：
- 评估处于精神病临床高风险的年轻人的阴性症状与功能之间的关系。
目的
处于精神病临床高风险的年轻人通常表现出明显的阴性症状和较差的功能，尽管两者之间的关系的大小和方向尚不清楚。本系统评价的目的是总结处于精神病临床高风险的样本中阴性症状与功能之间的关系。
方法
从一开始就搜索了电子数据库 CINAHL、EBM、Embase、MEDLINE 和 PsycINFO。如果研究报告了阴性症状与处于精神病临床高风险的年轻人的功能之间的关系，则将其纳入研究。相关系数 r 转换为 Cohen 的 d，使用转换后的值进行所有随机效应荟萃分析。
结果
41 项研究符合纳入标准，共包括 4574 名精神病临床高风险人群。阴性症状总分与较差的总体功能显著相关（d，-1.40；95%CI，-1.82 至-0.98；I = 79.4%；p <.001 [9 项研究，n = 782]）、社会功能（d，-1.10；95%CI，-1.27 至-0.93；I = 10.40%；p <.001 [12 项研究，n = 811]）和角色功能（d，-0.96；95%CI，-1.17 至-0.76；I = 41.1%；p <.001 [9 项研究，n = 881]）。此外，阴性症状与较差的前期功能始终相关。在检查阴性症状领域时，意志减退、快感缺失和情感迟钝分别与社会功能和角色功能较差显著相关且独立相关。就预测模型而言，阴性症状在多项研究中对较低的功能有预测作用。
结论
该荟萃分析表明，处于精神病临床高风险的年轻人的阴性症状与功能之间存在很强的关系。
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