Pelizza Lorenzo, Leuci Emanuela, Quattrone Emanuela, Azzali Silvia, Paulillo Giuseppina, Pupo Simona, Pellegrini Pietro
Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, 43100 Parma, Italy.
Department of Biomedical and NeuroMotor Sciences, Università di Bologna, via Pepoli n. 5, 40126 Bologna, Italy.
Clin Neuropsychiatry. 2023 Feb;20(1):39-47. doi: 10.36131/cnfioritieditore20230105.
Comorbid depression is quite common in early psychosis and specifically related to suicidal behavior and poor long-term outcomes. However, Depressive Symptoms (DS) are often neglected in both research and treatment, especially at the psychosis onset. The goals of this investigation were: (a) to longitudinally explore DS levels in patients with First Episode Psychosis (FEP) during 24 months of follow-up, and (b) to investigate the associations of DS with psychopathology and intervention components of an "Early Intervention in Psychosis" (EIP) program across the follow-up period.
The Global Assessment of Functioning (GAF) and the Positive And Negative Syndrome Scale (PANSS) were completed by 266 FEP subjects. A linear regression analysis with DS as the dependent parameter and psychopathological and treatment characteristics as independent variables was performed (both at baseline and across the follow-up period).
DS had enduring associations with PANSS "Positive Symptoms" and "Negative Symptoms" subscores. During the investigation, FEP subjects significantly improved their DS severity levels. This was related to the number of individual psychotherapy meetings supplied within the EIP protocol, as well as to a higher antidepressant dose and a lower antipsychotic dose prescribed during the follow-up.
DS are quite prominent in FEP, even at the recruitment time in EIP services. Nevertheless, DS severity tends to diminish overtime, especially with the provision of specialized EIP treatments.
共病抑郁在早期精神病中相当常见,且与自杀行为及不良的长期预后密切相关。然而,抑郁症状(DS)在研究和治疗中常常被忽视,尤其是在精神病发作初期。本研究的目的是:(a)纵向探究首发精神病(FEP)患者在24个月随访期间的DS水平,以及(b)在整个随访期间,研究DS与“精神病早期干预”(EIP)项目的精神病理学及干预成分之间的关联。
266名FEP受试者完成了功能总体评定量表(GAF)和阳性与阴性症状量表(PANSS)。以DS作为因变量,精神病理学和治疗特征作为自变量进行线性回归分析(在基线期及整个随访期间)。
DS与PANSS的“阳性症状”和“阴性症状”子量表得分存在持久关联。在研究期间,FEP受试者的DS严重程度显著改善。这与EIP方案中提供的个体心理治疗次数有关,也与随访期间更高的抗抑郁药剂量和更低的抗精神病药剂量有关。
DS在FEP中相当突出,即使在EIP服务的招募阶段也是如此。然而,DS严重程度往往会随着时间推移而降低,尤其是在提供专门的EIP治疗时。