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精神病风险综合征患儿和青少年样本中重度抑郁症和阴性症状减弱:CAPRIS 研究。

Major depressive disorder and attenuated negative symptoms in a child and adolescent sample with psychosis risk syndrome: the CAPRIS study.

机构信息

Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, Esplugues de Llobregat, 08950, Barcelona, Spain.

Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain.

出版信息

Eur Child Adolesc Psychiatry. 2022 Sep;31(9):1431-1440. doi: 10.1007/s00787-021-01793-8. Epub 2021 Apr 24.

Abstract

Some 70-80% of subjects with psychotic risk syndrome (PRS) have lifetime comorbidity, with depressive disorders being the most common. A high proportion of patients with PRS present nonspecific symptoms which can be confounding factors for diagnosis. Depressive and negative symptoms may be difficult to distinguish and it is important to differentiate them. The aim of this study is to assess the presence of depressive disorder in a child and adolescent sample of PRS and to examine the presence of negative symptoms and detect possible confounding characteristics between them and depressive symptoms. This is a naturalistic multi-site study with subjects who met PRS criteria. A sample of 89 PRS adolescent patients was included. Major depressive disorder (MDD) is the most prevalent comorbid disorder (34.83%). The sample was divided into patients who met criteria for MDD (PRS-MDD, n = 31) and those who did not have this disorder (PRS-ND, n = 44). We obtained significant differences in the attenuated negative symptoms (ANS) between PRS-MDD and PRS-ND (68.18 vs. 90.32%, respectively, p = 0.021). Subjects with MDD presented a higher score in ANS and Hamilton Depression Rating Scale (HDRS). Moreover, we obtained a correlation between negative symptomatology and HDRS score with a higher score on HDRS in subjects with higher negative symptom scores (r = 0.533, p < 0.001). More research is needed to fine tune differentiation between depressive and negative symptoms and learn more about the possible impact of MDD on PRS children and adolescents.

摘要

约 70-80%的精神病风险综合征 (PRS) 患者有终生共病,其中抑郁障碍最为常见。PRS 患者中有相当一部分存在非特异性症状,这些症状可能会对诊断造成混淆。抑郁和阴性症状可能难以区分,因此对其进行区分非常重要。本研究旨在评估 PRS 儿童和青少年样本中是否存在抑郁障碍,并检查阴性症状的存在情况,以及这些症状与抑郁症状之间是否存在可能的混淆特征。这是一项自然主义的多中心研究,研究对象符合 PRS 标准。纳入了 89 名 PRS 青少年患者。最常见的共病障碍是重性抑郁障碍(MDD,34.83%)。该样本分为符合 MDD 标准的患者(PRS-MDD,n=31)和不符合该疾病标准的患者(PRS-ND,n=44)。我们在 PRS-MDD 和 PRS-ND 之间发现了显著的减弱阴性症状(ANS)差异(分别为 68.18%和 90.32%,p=0.021)。MDD 患者的 ANS 和汉密尔顿抑郁评定量表(HDRS)评分较高。此外,我们还发现阴性症状学与 HDRS 评分之间存在相关性,即具有较高阴性症状评分的患者的 HDRS 评分也较高(r=0.533,p<0.001)。需要进一步研究以精确区分抑郁和阴性症状,并进一步了解 MDD 对 PRS 儿童和青少年的可能影响。

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