Mental Health Center Amager, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Schizophr Bull. 2024 Jul 27;50(4):871-880. doi: 10.1093/schbul/sbad185.
Nonpsychotic symptoms (depression, anxiety, obsessions, etc.) are frequent in schizophrenia-spectrum disorders and are usually conceptualized as comorbidity or transdiagnostic symptoms. However, in twentieth century foundational psychopathological literature, many nonpsychotic symptoms with specific phenomenology (here termed pseudoneurotic symptoms) were considered relatively typical of schizophrenia. In this prospective study, we investigated potential associations of pseudoneurotic symptoms with diagnostic status, functional outcome as well as psychopathological dimensions of schizophrenia.
First-admitted patients (N = 121) diagnosed with non-affective psychosis, schizotypal disorder, or other mental illness were examined at initial hospitalization and 5 years later with a comprehensive assessment of psychopathology. Informed by the literature, we constructed scales targeting pseudoneurotic symptoms and other, more general, nonpsychotic symptoms.
Pseudoneurotic symptoms aggregated in schizophrenia-spectrum groups compared to other mental illnesses and occurred at similar levels at baseline and follow-up. They longitudinally predicted poorer social and occupational functioning in schizophrenia-spectrum patients over a 5-year-period but not transition to schizophrenia-spectrum disorders from other mental illnesses. Finally, the level of pseudoneurotic symptoms correlated with disorder of basic self at both assessments and with positive and negative symptoms at follow-up. The scale targeting general nonpsychotic symptoms did not show this pattern of associations.
The study supports that a group of nonpsychotic symptoms, ie, pseudoneurotic symptoms, are associated with schizophrenia-spectrum disorders and linked with temporally stable psychopathology, particularly disorder of the basic self. Their prospective association with social and occupational functioning needs replication.
非精神病症状（抑郁、焦虑、强迫等）在精神分裂症谱系障碍中很常见，通常被概念化为共病或跨诊断症状。然而，在 20 世纪的基础精神病理学文献中，许多具有特定表现的非精神病症状（此处称为拟神经症症状）被认为是精神分裂症的典型症状。在这项前瞻性研究中，我们研究了拟神经症症状与诊断状况、功能结果以及精神分裂症的心理病理学维度之间的潜在关联。
首次入院的非情感性精神病、分裂型人格障碍或其他精神疾病患者（N=121）在入院时和 5 年后接受全面的精神病理学评估。根据文献，我们构建了针对拟神经症症状和其他更常见的非精神病症状的量表。
与其他精神疾病相比，拟神经症症状在精神分裂症谱系群体中聚集，在基线和随访时的水平相似。它们在 5 年内纵向预测了精神分裂症谱系患者的社会和职业功能较差，但不能预测从其他精神疾病向精神分裂症谱系障碍的转变。最后，拟神经症症状的水平与基本自我障碍在两个评估时以及与随访时的阳性和阴性症状相关。针对一般非精神病症状的量表没有表现出这种关联模式。
该研究支持一组非精神病症状，即拟神经症症状，与精神分裂症谱系障碍相关，并与稳定的精神病理学相关，特别是基本自我障碍。它们与社会和职业功能的前瞻性关联需要进一步研究。
