Montemagni Cristiana, Carluccio Anna, Brasso Claudio, Vischia Flavio, Rocca Paola
Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy.
Front Psychiatry. 2024 May 24;15:1381133. doi: 10.3389/fpsyt.2024.1381133. eCollection 2024.
The aim of the current study was 3-fold: 1) to examine the factorial structure of the Comprehensive Assessment of At-Risk Mental States (CAARMS) in help-seeking individuals undergoing an assessment on suspicion of psychosis risk; 2) to investigate the association of CAARMS factors with functioning; 3) and to test the association of any derived factors with the longitudinal outcome of transition to psychosis.
The study included 101 patients. First, a principal component analysis (PCA) was conducted using the Varimax rotation method. A minimum initial eigenvalues of greater than or equal to 1.0, analysis of Scree plots, percentage of variance explained by each component, reliability (Cronbach's alpha) of factors above 0.7 and Parallel Analysis were the criteria used to determine the appropriate number of factors Second, Spearman correlations were run to analyze the relationship between CAARMS factors and sociodemographic and functional variables (i.e. age, schooling, Social and Occupational Functioning Assessment Scale-SOFAS- and Health of the Nation Outcome Scales-HoNOS- scores). Third, we performed a Logistic regression analysis to evaluate the association between baseline CAARMS factors and the risk of transition to psychosis at the 6-month follow-up.
A total of 101 consecutive patiens were recruited. We found that: 1) a 6 factor model solution as the most appropriate, jointly accounting for 65% of the variance; 2) factors 1 ("negative-interpersonal"), 2 ("cognitive-disorganization"), 3 ("positive"), and 4 ("motor-physical changes") were negatively correlated with SOFAS total score; factors 1, 2, and 3 showed positive correlations with HoNOS total score; factors 2 and 3 present similar patterns of correlations, factor 3 manifesting the strongest association with HoNOS symptoms, HONOS and SOFAS total score. Both factors 5 and 6 show significant associations with HoNOS behavioral impairment; 3) after 6 months 28 participants (30.1%) converted to psychosis. Factors 2 and 3 were positively associated with the risk of transition to psychosis; whereas, the factor 5 ("affective factor") was negatively associated with the outcome variable.
It is thus crucial to recognize the type and severity of psychopathology in help-seeking individuals in order to intensive clinical monitoring of subclinical psychopathology risk profiles, and design specific care pathways.
本研究的目的有三个方面：1）检验在因疑似精神病风险而接受评估的求助个体中，综合风险精神状态评估（CAARMS）的因子结构；2）调查CAARMS各因子与功能的关联；3）检验任何派生因子与向精神病转变的纵向结果之间的关联。
该研究纳入了101名患者。首先，使用最大方差旋转法进行主成分分析（PCA）。确定适当因子数量的标准包括：最小初始特征值大于或等于1.0、碎石图分析、每个成分解释的方差百分比、因子的可靠性（克朗巴哈系数）高于0.7以及平行分析。其次，进行斯皮尔曼相关性分析，以分析CAARMS各因子与社会人口统计学和功能变量（即年龄、受教育程度、社会和职业功能评估量表-SOFAS-以及国民健康结果量表-HoNOS-得分）之间的关系。第三，我们进行逻辑回归分析，以评估基线CAARMS各因子与6个月随访时向精神病转变风险之间的关联。
共招募了101名连续的患者。我们发现：1）一个6因子模型解最为合适，共同解释了65%的方差；2）因子1（“消极人际”）、2（“认知紊乱”）、3（“积极”）和4（“运动-身体变化”）与SOFAS总分呈负相关；因子-1、2和3与HoNOS总分呈正相关；因子2和3呈现相似的相关模式，因子3与HoNOS症状、HoNOS和SOFAS总分的关联最强。因子5和6均与HoNOS行为损害有显著关联；3）6个月后，28名参与者（30.1%）转变为精神病。因子2和3与向精神病转变的风险呈正相关；而因子5（“情感因子”）与结果变量呈负相关。
因此，识别求助个体中精神病理学的类型和严重程度至关重要以便对亚临床精神病理学风险概况进行强化临床监测，并设计特定的护理途径。
