Kaleda V G, Omelchenko M A, Migalina V V
Mental Health Research Center, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(11. Vyp. 2):38-45. doi: 10.17116/jnevro202312311238.
To establish the risk of psychotic disorders in juvenile depression and to study the role of negative symptoms in its formation.
Seventy-four in-patients (19.6±2.3 years old), who were hospitalized for the first time in the clinic for a depressive episode, were examined. Psychometric scales HDRS, SOPS, SANS were used. The risk of manifestation of psychotic disorders was established in the presence of attenuated positive symptoms (APS) with values of at least one of the points P1, P2, P3 and P4 of the corresponding SOPS subscale more or equal to 3. The overall risk of schizophrenia spectrum disorders was established in the presence of attenuated negative symptoms (ANS) with values of at least one of the points H1-H6 of the negative SOPS subscale is more than or equal to 5. Statistical analysis was carried out using the Statistica 12 program.
During the psychometric assessment of patients at admission, four groups were identified based on the presence of APS and ANS: group 1 (APS+ANS), group 2 (APS), group 3 (ANS) and a comparison group without APS/ANS. It was found that the presence of APS and ANS in the structure of depression increased its severity (=109.0; =0.009). Assessment of the ANS severity on the negative subscale of SOPS and on the SANS demonstrated quantitative differences with the highest representation of negative symptoms in the corresponding groups (APS+ANS and ANS) with significant differences in total scores in the comparison group (=93.0; =0.004 and =85.0; =0.002). When studying the structure of negative symptoms according to the SANS subscales, patients with APS differed in a lower degree of severity of negative symptoms only according to the «Avolition-Apathy» subscale (=141.5; =0.028). Patients from the comparison group, despite significant differences in other psychopathological symptoms, showed lower values only for the SANS subscales «Affective flattening» (=112.0; =0.02) and, to a greater extent, «Avolition-Apathy» (=84.0; =0.002).
Based on the presence of prodromal symptoms in the structure of juvenile depression and their dynamics during therapy, one can assume not only a different degree of risk of endogenous psychoses, but also their nosological affiliation.
确定青少年抑郁症中精神障碍的风险，并研究阴性症状在其形成中的作用。
对74例首次因抑郁发作入院治疗的住院患者（19.6±2.3岁）进行检查。使用了心理测量量表HDRS、SOPS、SANS。当相应SOPS子量表的P1、P2、P3和P4点中至少有一点的值大于或等于3时，存在亚临床阳性症状（APS），则确定存在精神障碍的风险。当阴性SOPS子量表的H1 - H6点中至少有一点的值大于或等于5时，存在亚临床阴性症状（ANS），则确定精神分裂症谱系障碍的总体风险。使用Statistica 12程序进行统计分析。
在入院时对患者进行心理测量评估期间，根据APS和ANS的存在情况分为四组：第1组（APS + ANS）、第2组（APS）、第3组（ANS）和无APS/ANS的对照组。发现抑郁症结构中存在APS和ANS会增加其严重程度（=109.0；=0.009）。对SOPS阴性子量表和SANS上的ANS严重程度进行评估，结果显示相应组（APS + ANS和ANS）中阴性症状的表现最为突出，总分在对照组中有显著差异（=93.0；=0.004和=85.0；=0.002）。根据SANS子量表研究阴性症状的结构时，仅根据“意志缺乏 - 情感淡漠”子量表，有APS的患者阴性症状严重程度较低（=141.5；=0.028）。对照组患者尽管在其他精神病理症状上有显著差异，但仅在SANS子量表“情感平淡”（=112.0；=0.02）以及在更大程度上“意志缺乏 - 情感淡漠”（=84.0；=0.002）上显示出较低的值。
根据青少年抑郁症结构中前驱症状的存在及其治疗过程中的动态变化，不仅可以假设内源性精神病的风险程度不同，还可以假设其疾病分类归属。
