Department of Psychiatry, Makerere University, Kampala, Uganda.
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Early Interv Psychiatry. 2021 Dec;15(6):1713-1720. doi: 10.1111/eip.13120. Epub 2021 Jan 14.
The risk factors for a first episode of psychosis in low and middle-income countries (LMICs) are not well described. The study compared the association of different risk factors in patients with first-episode psychosis patients and healthy controls from an LMIC context.
A comparative, descriptive, cross-sectional study was performed in antipsychotic naïve first-episode psychosis patients and healthy controls at the National referral hospital in Uganda. Standardized tools were used to assess sociodemographic (e.g., age, sex, socioeconomic status) and clinical (e.g., childhood trauma, quality of life) variables. First episode psychosis participants were compared to healthy controls in terms of sociodemographic and clinical variables, and logistic regression was used to determine predictors of FEP.
Our final sample included 198 antipsychotic naïve first-episode psychosis participants and 82 controls. Most participants were female (68.5%) with a mean age of 29.4 years. After adjusting for age and sex, FEP patients when compared to controls were less likely to be female [AOR 0.18 (95%CI 0.03-0.85; p = .031)], more likely to have experienced emotional abuse [AOR 1.30 (95%CI 1.02-1.65; p = .032)] and more likely to have a poor quality of life [AOR 0.93 (95%CI 0.89-0.97; p = .002)].
The risk factors for a first episode of psychosis in this low and middle-income population were like those described in high-income countries. Further studies on interventions to prevent the transition to psychotic disorders in this sub-groups of patients are recommended. Also, the use of specialized early intervention services in improving the quality of life needs to be evaluated.
中低收入国家（LMICs）首次出现精神病的风险因素尚未得到充分描述。本研究比较了来自 LMIC 背景的首发精神病患者和健康对照者的不同风险因素之间的关联。
在乌干达国家转诊医院，对未经抗精神病药物治疗的首发精神病患者和健康对照者进行了一项比较性、描述性、横断面研究。使用标准化工具评估社会人口统计学（例如年龄、性别、社会经济地位）和临床变量（例如儿童期创伤、生活质量）。比较首发精神病患者与健康对照者的社会人口统计学和临床变量，并使用逻辑回归确定 FEP 的预测因素。
我们的最终样本包括 198 名未经抗精神病药物治疗的首发精神病患者和 82 名对照者。大多数参与者为女性（68.5%），平均年龄为 29.4 岁。在调整年龄和性别后，与对照组相比，FEP 患者女性比例较低[优势比（OR）0.18（95%置信区间 0.03-0.85；p=0.031)]，更有可能经历情感虐待[OR 1.30（95%置信区间 1.02-1.65；p=0.032)]，且生活质量更差[OR 0.93（95%置信区间 0.89-0.97；p=0.002)]。
在这个中低收入人群中，首发精神病的风险因素与高收入国家描述的风险因素相似。建议进一步研究针对这些患者亚群的干预措施，以预防向精神病障碍的转变。此外，还需要评估专门的早期干预服务在提高生活质量方面的作用。
