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年轻人治疗后精神病发病的时间变化。

Temporal variation in the incidence of treated psychotic disorders in young people.

机构信息

Univ Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires "H.Mondor", DMU IMPACT, INSERM, IMRB, translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France.

Orygen, 35 Poplar rd, Parkville, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.

出版信息

Schizophr Res. 2021 May;231:221-226. doi: 10.1016/j.schres.2021.03.011. Epub 2021 Apr 22.

Abstract

INTRODUCTION

The incidence of psychotic disorders varies between geographical areas, however less is known about whether it varies over time in the same region. Analyzing this temporal variation of incidence could improve the allocation of healthcare resources and our understanding of the aetiology of psychotic disorders. This study aimed to determine whether there was a change in the incidence of psychotic disorders over a six-year period.

METHODS

Young people aged 15 to 24 presenting with a first episode of psychosis (FEP) attending an early intervention service in Melbourne between 2011 and 2016 were included. The population at-risk was determined from the two corresponding census periods and analyses were adjusted for age, sex and migrant status.

RESULTS

A total of 1217 young people presented with a FEP over the six-year period and the crude incidence rate in 2011 was 102.4 per 100,000 population at-risk, compared to 125.4 in 2016. There was an increase in the incidence by 33% in 2015 (aIRR = 1.33, 95% CI 1.09-1.63) and 28% in 2016 (aIRR = 1.28, 95% CI 1.05-1.56). When examined according to diagnostic groups, there was an increase in the incidence of substance-induced psychotic disorders among females in 2015 (aIRR = 4.62, 95% CI 1.02-20.8).

DISCUSSION

This study shows significant temporal variations in the incidence of treated psychotic disorders. These findings demonstrate that early intervention services should continually monitor incidence case numbers and funding should be provided accordingly, to ensure the required intensive and comprehensive treatments can be sustained.

摘要

介绍

精神障碍的发病率在不同地区有所不同,但对于同一地区发病率是否随时间变化知之甚少。分析发病率的这种时间变化可以改善医疗资源的分配,并增进我们对精神障碍病因的理解。本研究旨在确定在六年期间是否存在精神障碍发病率的变化。

方法

纳入 2011 年至 2016 年间在墨尔本接受早期干预服务的 15 至 24 岁首次出现精神病发作(FEP)的年轻人。高危人群是根据两个相应的人口普查时期确定的,分析结果针对年龄、性别和移民身份进行了调整。

结果

在六年期间,共有 1217 名年轻人出现 FEP,2011 年的粗发病率为每 100,000 名高危人群 102.4 例,而 2016 年为 125.4 例。2015 年发病率增加了 33%(调整后发病率比[aIRR] = 1.33,95%置信区间 [CI] 1.09-1.63),2016 年增加了 28%(aIRR = 1.28,95% CI 1.05-1.56)。按诊断组别检查时,2015 年女性因物质所致精神障碍的发病率增加(调整后发病率比[aIRR] = 4.62,95%置信区间 [CI] 1.02-20.8)。

讨论

本研究显示治疗性精神障碍的发病率存在显著的时间变化。这些发现表明,早期干预服务应持续监测发病率病例数,并相应提供资金,以确保可以维持所需的密集和全面的治疗。

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