Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
Schizophr Res. 2024 Jan;263:229-236. doi: 10.1016/j.schres.2022.05.026. Epub 2022 Jun 3.
The long-term stability of neuromotor domains assessed at the first episode of psychosis (FEP) and their ability for predicting a number of outcomes remains largely unknown, and this study addressed these issues.
This was a longitudinal study of 243 participants with FEP who were assessed at baseline for background variables and parkinsonism, dyskinesia, neurological soft signs (NSS) and catatonia, and reassessed 21 years later for the same neuromotor variables, psychopathology, functioning, personal recovery, cognitive performance and medical comorbidity. Stability of neuromotor ratings was assessed using the intraclass correlations coefficient and associations between the predictors and outcomes were examined using univariate and multivariate statistics.
Baseline dyskinesia and NSS ratings showed excellent stability over time whereas that for parkinsonism and catatonia was relatively low. Neuromotor dysfunction at follow-up was independently predicted by a family history of schizophrenia, obstetric complications, neurodevelopmental delay, low premorbid IQ and baseline ratings of dyskinesia and NSS. Moreover, baseline dyskinesia and NSS ratings independently predicted more positive and negative symptoms, poor functioning and less personal recovery; catatonia predicted less personal recovery and more medical comorbidity. Baseline neuromotor ratings explained between 4% (for medical comorbidity) and 34% (for neuromotor dysfunction) of the variance in the outcomes. Lastly, neuromotor dysfunction at baseline highly predicted clinical staging at follow-up.
Baseline neuromotor domains show variable stability over time and relate distinctively to very long-term outcomes. Both baseline dyskinesia and NSS are trait markers of the disease process and robust predictors of the outcomes.
在首次精神病发作（FEP）时评估的神经运动域的长期稳定性及其对多种结果的预测能力在很大程度上仍然未知，本研究解决了这些问题。
这是一项对 243 名 FEP 患者的纵向研究，他们在基线时评估了背景变量和帕金森病、运动障碍、神经软体征（NSS）和紧张症，并在 21 年后重新评估了相同的神经运动变量、精神病理学、功能、个人康复、认知表现和合并症。使用组内相关系数评估神经运动评分的稳定性，并使用单变量和多变量统计检验预测因子与结果之间的关联。
基线运动障碍和 NSS 评分显示出良好的长期稳定性，而帕金森病和紧张症的稳定性相对较低。随访时的神经运动功能障碍独立预测因素为精神分裂症家族史、产科并发症、神经发育迟缓、低产前智商和基线运动障碍和 NSS 评分。此外，基线运动障碍和 NSS 评分独立预测了更多的阳性和阴性症状、功能不佳和个人康复程度降低；紧张症预测了个人康复程度降低和更多的合并症。基线神经运动评分解释了结果中 4%（用于合并症）至 34%（用于神经运动功能障碍）的差异。最后，基线神经运动功能障碍高度预测了随访时的临床分期。
基线神经运动域显示出随时间变化的可变稳定性，并且与非常长期的结果有独特的关系。基线运动障碍和 NSS 都是疾病过程的特质标志物，是结果的有力预测因子。
