Orygen, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
J Psychiatr Res. 2021 Aug;140:373-380. doi: 10.1016/j.jpsychires.2021.05.038. Epub 2021 Jun 4.
There is a need to better understand the interrelationships between positive and negative symptoms of recent-onset schizophrenia spectrum disorders (SSD) and co-occurring depressive symptoms. Aims were to determine: (1) whether depressive symptoms are best conceptualised as distinct from, or intrinsic to, positive and negative symptoms; and (2) bridging symptoms.
Network analysis was applied to data from 198 individuals with depressive and psychotic symptoms in SSD from the Psychosis Recent Onset GRoningen Survey (PROGR-S). Measures were: Montgomery-Åsberg Depression Rating Scale and Positive and Negative Syndrome Scale.
Positive symptoms were just as likely to be associated with depressive and negative symptoms, and had more strong associations with depressive than negative symptoms. Negative symptoms were more likely to be associated with depressive than positive symptoms, and had more strong associations with depressive than positive symptoms. Suspiciousness and stereotyped thinking bridged between positive and depressive symptoms, and apparent sadness and lassitude between negative and depressive symptoms.
Depressive symptoms might be best conceptualised as intrinsic to positive and negative symptoms pertaining to deficits in motivation and interest in the psychotic phase of SSD. Treatments targeting bridges between depressive and positive symptoms, and depressive and such negative symptoms, might prevent or improve co-occurring depressive symptoms, or vice-versa, in the psychotic phase of SSD.
需要更好地理解新近发病的精神分裂症谱系障碍(SSD)的阳性和阴性症状与共病抑郁症状之间的相互关系。目的是确定:(1)抑郁症状是否最好被视为与阳性和阴性症状不同,还是内在相关;(2)桥接症状。
对来自精神分裂症发病近期的格罗宁根调查(PROGR-S)中 198 名有抑郁和精神病症状的 SSD 患者的数据进行网络分析。测量工具为:蒙哥马利-阿斯伯格抑郁评定量表和阳性与阴性症状量表。
阳性症状与抑郁和阴性症状同样相关,与抑郁症状的关联比与阴性症状的关联更强。阴性症状与抑郁症状比与阳性症状更相关,与抑郁症状的关联比与阳性症状的关联更强。多疑和刻板思维在阳性和抑郁症状之间架起桥梁,而明显的悲伤和疲倦在阴性和抑郁症状之间架起桥梁。
抑郁症状可能最好被视为与 SSD 精神病阶段的动机和兴趣缺陷相关的阳性和阴性症状的内在部分。针对抑郁和阳性症状之间以及抑郁和此类阴性症状之间的桥梁进行治疗,可能会预防或改善 SSD 精神病阶段的共病抑郁症状,反之亦然。