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首发精神病青年成人再入院的预测因素:一项为期12个月随访的多中心回顾性研究。

Predictors of Readmission in Young Adults with First-Episode Psychosis: A Multicentric Retrospective Study with a 12-Month Follow-Up.

作者信息

Besana Filippo, Civardi Serena Chiara, Mazzoni Filippo, Carnevale Miacca Giovanni, Arienti Vincenzo, Rocchetti Matteo, Politi Pierluigi, Martiadis Vassilis, Brondino Natascia, Olivola Miriam

机构信息

Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy.

Department of Mental Health and Addiction, ASST Pavia, 27100 Pavia, Italy.

出版信息

Clin Pract. 2024 Jun 24;14(4):1234-1244. doi: 10.3390/clinpract14040099.

Abstract

BACKGROUND

A significant number of young individuals are readmitted one or more times shortly after their first episode of psychosis. Readmission may represent a marker of psychopathological vulnerability. Our primary aim was to evaluate the impact of clinical and socio-demographic variables on readmission at 12-month follow-up. Secondly, our goal was to determine whether the use of Long-Acting Injection (LAI) antipsychotics provides notable benefits compared to oral medications in preventing subsequent readmissions.

SUBJECTS AND METHODS

80 patients hospitalised for the first time with a diagnosis of psychotic disorder (ICD-10 criteria) were retrospectively assessed through clinical records. The mean age was 21.7 years. Patients were predominantly male (n = 62, 77.5%), and 55 subjects had at least 8 years of education. 50% of the sample was "NEET" (not in education, employment, or training).

RESULTS

35 patients (43.8%) were discharged with a LAI antipsychotic, while 45 (56.2%) recieved oral antipsychotic therapy. Substance use ( = 0.04) and oral antipsychotics at discharge ( = 0.003) were significantly associated with readmission at 1 year. We did not find any significant predictors of being discharged with LAI therapy.

CONCLUSION

Our findings underlined the importance of identifying patients at risk of readmission in order to prevent future rehospitalization and promote appropriate prevention strategies. LAIs should be considered as a first-choice treatment for patients hospitalised for FEP since they proved to be effective in preventing relapse.

摘要

背景

相当数量的年轻人在首次精神病发作后不久会再次入院一次或多次。再次入院可能是精神病理易感性的一个标志。我们的主要目的是评估临床和社会人口统计学变量对12个月随访时再次入院的影响。其次,我们的目标是确定与口服药物相比,使用长效注射(LAI)抗精神病药物在预防后续再次入院方面是否具有显著益处。

受试者与方法

通过临床记录对80例首次因精神障碍(国际疾病分类第10版标准)住院的患者进行回顾性评估。平均年龄为21.7岁。患者以男性为主(n = 62,77.5%),55名受试者至少接受过8年教育。样本的50%为“啃老族”(未接受教育、未就业或未接受培训)。

结果

35例患者(43.8%)出院时使用了LAI抗精神病药物,而45例(56.2%)接受了口服抗精神病药物治疗。物质使用(P = 0.04)和出院时使用口服抗精神病药物(P = 0.003)与1年内再次入院显著相关。我们没有发现任何与出院时接受LAI治疗相关的显著预测因素。

结论

我们的研究结果强调了识别有再次入院风险患者的重要性,以便预防未来的再次住院并促进适当的预防策略。LAIs应被视为首次发作精神病(FEP)住院患者的首选治疗方法,因为它们已被证明在预防复发方面有效。

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