居住在不稳定住房或无家可归的成年人中药物引起的运动障碍与精神病的关系。
Relationship between drug-induced movement disorders and psychosis in adults living in precarious housing or homelessness.
机构信息
Department of Anesthesiology, Pharmacology & Therapeutics, 2176 Health Sciences Mall, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada; British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada.
British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
出版信息
J Psychiatr Res. 2024 Feb;170:290-296. doi: 10.1016/j.jpsychires.2024.01.003. Epub 2024 Jan 3.
BACKGROUND
Studies have reported positive associations between drug-induced movement disorders (DIMDs) and symptoms of psychosis in patients with schizophrenia. However, it is not clear which subtypes of symptoms are related to each other, and whether one symptom precedes another. The current report assessed both concurrent and temporal associations between DIMDs and symptoms of psychosis in a community-based sample of homeless individuals.
METHODS
Participants were recruited in Vancouver, Canada. Severity of DIMDs and psychosis was rated annually, allowing for the analysis of concurrent associations between DIMDs and Positive and Negative Syndrome Scale (PANSS) five factors. A brief version of the PANSS was rated monthly using five psychotic symptoms, allowing for the analysis of their temporal associations with DIMDs. Mixed-effects linear and logistic regression models were used to assess the associations.
RESULTS
401 participants were included, mean age of 40.7 years (SD = 11.2) and 77.4% male. DIMDs and symptoms of psychosis were differentially associated with each other, in which the presence of parkinsonism was associated with greater negative symptoms, dyskinesia with disorganized symptoms, and akathisia with excited symptoms. The presence of DIMDs of any type was not associated with depressive symptoms. Regarding temporal associations, preceding delusions and unusual thought content were associated with parkinsonism, whereas dyskinesia was associated with subsequent conceptual disorganization.
CONCLUSIONS
The current study found significant associations between DIMDs and symptoms of psychosis in individuals living in precarious housing or homelessness. Moreover, there were temporal associations between parkinsonism and psychotic symptoms (delusions or unusual thought content), and the presence of dyskinesia was temporally associated with higher odds of clinically relevant conceptual disorganization.
背景
研究报告称，药物引起的运动障碍（DIMD）与精神分裂症患者的精神病症状之间存在正相关。然而，目前尚不清楚哪些症状亚型相互关联，以及是否一种症状先于另一种症状出现。本报告评估了在一个基于社区的无家可归者样本中，DIMD 与精神病症状之间的同时性和时间性关联。
方法
参与者在加拿大温哥华招募。每年评估 DIMD 和精神病的严重程度，允许分析 DIMD 与阳性和阴性综合征量表（PANSS）五个因素之间的同时性关联。使用五种精神病症状对 PANSS 的简短版本进行每月评估，允许分析它们与 DIMD 的时间性关联。使用混合效应线性和逻辑回归模型评估关联。
结果
共纳入 401 名参与者，平均年龄为 40.7 岁（标准差=11.2），77.4%为男性。DIMD 和精神病症状彼此不同，帕金森病的存在与更严重的阴性症状相关，运动障碍与混乱症状相关，静坐不能与兴奋症状相关。任何类型的 DIMD 都与抑郁症状无关。关于时间性关联，前驱妄想和异常思维内容与帕金森病相关，而运动障碍与随后的概念混乱相关。
结论
本研究在居住在不稳定住房或无家可归的个体中发现了 DIMD 与精神病症状之间的显著关联。此外，帕金森病与精神病症状（妄想或异常思维内容）之间存在时间性关联，而运动障碍的存在与更高的临床相关概念混乱的可能性相关。
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