Izquierdo Ana, Cabello María, Leal Itziar, Mellor-Marsá Blanca, Ayora Miriam, Bravo-Ortiz María-Fe, Rodriguez-Jimenez Roberto, Ibáñez Ángela, MacDowell Karina S, Malpica Norberto, Díaz-Marsá Marina, Baca-García Enrique, Fares-Otero Natalia E, Melero Helena, López-García Pilar, Díaz-Caneja Covadonga M, Arango Celso, Ayuso-Mateos Jose Luis
Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, CIBERSAM, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
Institute of Psychiatry and Mental Health, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain.
J Psychiatr Res. 2021 Apr;136:265-273. doi: 10.1016/j.jpsychires.2021.02.024. Epub 2021 Feb 15.
The relationship between psychotic symptoms and global measures of functioning has been widely studied. No previous study has assessed so far the interplay between specific clinical symptoms and particular areas of functioning in first-episode psychosis (FEP) using network analysis methods. A total of 191 patients with FEP (age 24.45 ± 6.28 years, 64.9% male) participating in an observational and longitudinal study (AGES-CM) comprised the study sample. Functioning problems were assessed with the WHO Disability Assessment Schedule (WHODAS), whereas the Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity. Network analysis were conducted with the aim of analysing the patterns of relationships between the different dimensions of functioning and PANSS symptoms and factors at baseline. According to our results, the most important nodes were "conceptual disorganization", "emotional withdrawal", "lack of spontaneity and flow of conversation", "delusions", "unusual thought content", "dealing with strangers" and "poor rapport". Our findings suggest that these symptoms and functioning dimensions should be prioritized in the clinical assessment and management of patients with FEP. These areas may also become targets of future early intervention strategies, so as to improve quality of life in this population.
精神病性症状与整体功能指标之间的关系已得到广泛研究。迄今为止,尚无先前的研究使用网络分析方法评估首发精神病(FEP)中特定临床症状与特定功能领域之间的相互作用。共有191例FEP患者(年龄24.45±6.28岁,64.9%为男性)参与了一项观察性纵向研究(AGES-CM),构成了研究样本。使用世界卫生组织残疾评定量表(WHODAS)评估功能问题,而阳性和阴性症状量表(PANSS)用于评估症状严重程度。进行网络分析的目的是分析基线时功能的不同维度与PANSS症状及因素之间的关系模式。根据我们的结果,最重要的节点是“概念紊乱”、“情感退缩”、“缺乏自发性和对话流畅性”、“妄想”、“异常思维内容”、“与陌生人打交道”和“关系不良”。我们的研究结果表明,在FEP患者的临床评估和管理中,应优先考虑这些症状和功能维度。这些领域也可能成为未来早期干预策略的目标,以提高该人群的生活质量。