Kay S R, Lindenmayer J P
J Nerv Ment Dis. 1987 Mar;175(3):152-60. doi: 10.1097/00005053-198703000-00005.
In a prospective 2-year follow-up of 37 young acute schizophrenics, we examined the predictive significance and relative contribution of historical, genealogical, course, and clinical dimensions. Patients were evaluated multidimensionally at index admission and after 21 to 33 months, at which time 19 cooperated in follow-up involving clinical, functional, psychometric, and objective outcome measures. Multiple regression analysis found that combinations of 3 to 4 index variables significantly predicted 13 of 14 outcome measures, yielding multiple R values between .63 and .93 (X = .78). In total, a set of eight parameters contributed in explaining the outcome variance. The strongest overall predictor of favorable outcome was baseline negative syndrome. Other significant predictors were good premorbid school functioning, favorable prior disposition, sudden onset of illness, nonparanoid subdiagnosis, family history of alcoholism, psychomotor retardation, and depression. Accordingly, a patient's premorbid adjustment, course of illness, and presenting clinical profile provided nonoverlapping sources of outcome prediction. Of these three dimensions, it was proposed that the prognostic significance of the clinical profile may be phase specific, carrying different implications when assessed in the acute vs. chronic stage of illness.
在一项对37名年轻急性精神分裂症患者进行的为期2年的前瞻性随访中，我们研究了病史、家谱、病程和临床维度的预测意义及相对贡献。在首次入院时以及21至33个月后对患者进行多维度评估，此时有19名患者配合进行了涉及临床、功能、心理测量和客观结局指标的随访。多元回归分析发现，3至4个指标变量的组合显著预测了14项结局指标中的13项，复相关系数（R）值在0.63至0.93之间（均值 = 0.78）。总体而言，一组8个参数有助于解释结局差异。预后良好的最强总体预测因素是基线阴性症状。其他显著的预测因素包括病前学校功能良好、既往性格良好、起病突然、非偏执亚型诊断、酗酒家族史、精神运动迟缓以及抑郁。因此，患者的病前适应情况、病程以及当前临床特征提供了相互不重叠的结局预测来源。在这三个维度中，有人提出临床特征的预后意义可能具有阶段特异性，在疾病的急性期与慢性期进行评估时具有不同的含义。
