Prakash Jyoti, Saini R K, Srivastava Kalpana, Chatterjee Kaushik, Basannar D R, Mohan Prafull
Professor, Department of Psychiatry, Armed Forces Medical College, Pune, India.
Professor (Psychiatry), Command Hospital (Eastern Command), Kolkata, India.
Med J Armed Forces India. 2023 Sep-Oct;79(5):539-546. doi: 10.1016/j.mjafi.2021.04.013. Epub 2021 Sep 1.
Study of first episode psychosis (FEP), an episode of psychotic nature, which manifests for the first time in an individual in the longitudinal continuum of his/her illness, has been a matter of research interest in recent years, as this may give more insight to the overall phenomenology and course of psychotic illnesses.
A study was undertaken to evaluate course and outcome of first episode psychosis. A total of 100 consecutive inpatients were selected for the study. Informed consent was obtained. Structured Proforma was used for recording psychosocial profiles and relevant medical history. Brief Psychiatric Rating Scale (BPRS) was given to assess the severity of psychopathology; Positive and Negative Symptom Scale (PANSS) to assess the severity of psychosis; Becks Suicidal Ideation Scale (BSI) to assess the extent of suicidality and Global Assessment of Functioning (GAF) to assess global functioning of the individual. The assessment was done at baseline, at six months, and at one year.
First episode psychosis constituted around a tenth of the caseload. It commonly affected people in the third decade of life. There was an improvement in 92% of the cases over a year of study. Schizophrenia constituted the majority of first episode psychosis. The history of smoking was relatively higher in acute and transient psychotic disorders. Age inversely correlated with the severity of psychopathology. There was no difference in improvement in psychopathology over time in patients of schizophrenia and related disorder vis--vis other psychotic disorders.
Our study did not find any significantly varied sociodemographic factors in the course and outcome of the illness. It also refuted the schism between various types of psychosis based on the current classificatory system. It draws our attention toward the unitary concept of psychosis and is a call to re-think our strategies in the management of psychosis.
首发精神病（FEP）是指在个体疾病的纵向发展过程中首次出现的具有精神病性特征的发作，近年来一直是研究热点，因为这可能为精神病性疾病的整体现象学和病程提供更多见解。
开展一项研究以评估首发精神病的病程和结局。共选取100例连续住院患者作为研究对象。获得了知情同意。使用结构化表格记录社会心理状况和相关病史。采用简明精神病评定量表（BPRS）评估精神病理学严重程度；阳性和阴性症状量表（PANSS）评估精神病严重程度；贝克自杀观念量表（BSI）评估自杀倾向程度；总体功能评定量表（GAF）评估个体的整体功能。在基线、6个月和1年时进行评估。
首发精神病约占病例总数的十分之一。它通常影响30岁左右的人群。在一年的研究期间，92%的病例有改善。精神分裂症占首发精神病的大多数。急性和短暂性精神病性障碍患者的吸烟史相对较高。年龄与精神病理学严重程度呈负相关。精神分裂症及相关障碍患者与其他精神病性障碍患者相比，精神病理学随时间的改善情况没有差异。
我们的研究未发现疾病病程和结局中存在任何显著不同的社会人口学因素。它也反驳了基于当前分类系统的各类精神病之间的分裂观点。它促使我们关注精神病的单一概念，并呼吁重新思考我们在精神病管理中的策略。
