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使用潜在类别增长分析,在一个为期两年随访的首发精神病队列中探索功能损害和基线预测因素的风险及复原力特征。

Exploring Risk and Resilient Profiles for Functional Impairment and Baseline Predictors in a 2-Year Follow-Up First-Episode Psychosis Cohort Using Latent Class Growth Analysis.

作者信息

Salagre Estela, Grande Iria, Solé Brisa, Mezquida Gisela, Cuesta Manuel J, Díaz-Caneja Covadonga M, Amoretti Silvia, Lobo Antonio, González-Pinto Ana, Moreno Carmen, Pina-Camacho Laura, Corripio Iluminada, Baeza Immaculada, Bergé Daniel, Verdolini Norma, Carvalho André F, Vieta Eduard, Bernardo Miquel

机构信息

Bipolar and Depressive Disorders Unit, Hospital Clinic, Biomedical Research Networking Center for Mental Health Network (CIBERSAM), August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain.

Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Department of Medicine, Institut de Neurociències, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Universitat de Barcelona, 08036 Barcelona, Spain.

出版信息

J Clin Med. 2020 Dec 28;10(1):73. doi: 10.3390/jcm10010073.

Abstract

Being able to predict functional outcomes after First-Episode Psychosis (FEP) is a major goal in psychiatry. Thus, we aimed to identify trajectories of psychosocial functioning in a FEP cohort followed-up for 2 years in order to find premorbid/baseline predictors for each trajectory. Additionally, we explored diagnosis distribution within the different trajectories. A total of 261 adults with FEP were included. Latent class growth analysis identified four distinct trajectories: Mild impairment-Improving trajectory (Mi-I) (38.31% of the sample), Moderate impairment-Stable trajectory (Mo-S) (18.39%), Severe impairment-Improving trajectory (Se-I) (12.26%), and Severe impairment-Stable trajectory (Se-S) (31.03%). Participants in the Mi-I trajectory were more likely to have higher parental socioeconomic status, less severe baseline depressive and negative symptoms, and better premorbid adjustment than individuals in the Se-S trajectory. Participants in the Se-I trajectory were more likely to have better baseline verbal learning and memory and better premorbid adjustment than those in the Se-S trajectory. Lower baseline positive symptoms predicted a Mo-S trajectory vs. Se-S trajectory. Diagnoses of Bipolar disorder and Other psychoses were more prevalent among individuals falling into Mi-I trajectory. Our findings suggest four distinct trajectories of psychosocial functioning after FEP. We also identified social, clinical, and cognitive factors associated with more resilient trajectories, thus providing insights for early interventions targeting psychosocial functioning.

摘要

能够预测首次发作精神病(FEP)后的功能结局是精神病学的一个主要目标。因此,我们旨在确定一个FEP队列中随访2年的社会心理功能轨迹,以便找到每个轨迹的病前/基线预测因素。此外,我们还探讨了不同轨迹内的诊断分布情况。总共纳入了261名患有FEP的成年人。潜在类别增长分析确定了四种不同的轨迹:轻度损害-改善轨迹(Mi-I)(占样本的38.31%)、中度损害-稳定轨迹(Mo-S)(18.39%)、重度损害-改善轨迹(Se-I)(12.26%)和重度损害-稳定轨迹(Se-S)(31.03%)。与Se-S轨迹中的个体相比,Mi-I轨迹中的参与者更有可能具有较高的父母社会经济地位、不太严重的基线抑郁和阴性症状以及更好的病前适应能力。与Se-S轨迹中的参与者相比,Se-I轨迹中的参与者更有可能具有更好的基线言语学习和记忆能力以及更好的病前适应能力。较低的基线阳性症状预测为Mo-S轨迹而非Se-S轨迹。双相情感障碍和其他精神病的诊断在Mi-I轨迹中的个体中更为普遍。我们的研究结果表明了FEP后社会心理功能的四种不同轨迹。我们还确定了与更具恢复力的轨迹相关的社会、临床和认知因素,从而为针对社会心理功能的早期干预提供了见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/7796026/2ecd7ae1c001/jcm-10-00073-g0A1.jpg

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